Frist explains Medicare bill to health leaders

By Julie Fann
Star Staff

BLOUNTVILLE -- Senate Majority Leader Bill Frist, equipped with a Diet Pepsi his press team placed on a conference room table for him, sat down with area health leaders Wednesday at Northeast State Technical Community College to discuss the new Medicare bill the president recently signed into law.
   After introductory comments from Dean of Quillen College of Medicine Ronald Franks, Frist reminded attendees that, on Dec. 17 a year ago, he had no idea he would be leading the U.S. Senate.
   "My overall approach in government hasn't changed. It really is listening like a doctor does to a patient, collecting information and then acting ... to deliver to the American people," he said.
   Frist listened to accolades from health leaders in the Tri-Cities region and also addressed concerns many have about details of the bill, which, among other things, will provide significant prescription drug coverage for the elderly beginning with discount drug cards on June 1, 2004. The drug cards will provide 10 to 25 percent off the retail price of most drugs. Full drug benefits will begin in 2006.
   "Those of us in the legislative process talk about politicians decorating legislation like Christmas trees. Prescription drug coverage is a start, but on the branches (of this bill) are possibilities for a much brighter future," said Elliott Moore, governor of affairs for Mountain States Health Alliance.
   The government will spend nearly $400 billion over the next 10 years to subsidize prescription drug coverage, and at the same time will encourage private insurance companies to offer plans to seniors who now receive benefits under terms fixed by the federal government.
   Seniors will have the option, under the new bill, to change their coverage from former employers or not, the president clarified. But that option may not exist for some seniors. The Congressional Budget Office estimates that 2.7 million retirees will lose the drug coverage they now receive from former employers, although other projections are smaller.
   It is the issue of retirees losing coverage that spawned a question from Dr. John Falls, a retired Ph.D. from East Tennessee State University who is an AARP representative. "The point I want to make is if the company (employer) drops the supplemental insurance, then this insurance wouldn't be as good as what they now have," he said.
   Frist said, "We don't know exactly what they have today. But the real problem is, what if this bill didn't pass? They (the employer) were going to drop it anyway, and then there's no alternative. If they drop it now, they have no alternative in many cases. For the first time, through the government working through private plans, they're going to have a choice."
   After paying for the first $250 in prescriptions, seniors will be responsible for 25 percent of the next $2,000 in drug costs. Between $2,250 and $5,100 in drug costs, the government will pay nothing. Over $5,100, the government pays all but 5 percent of prescription drug costs.
   Dean Rosen, who Frist said wrote nearly half of the new bill, explained two standard tests seniors must pass to qualify for the program - income and assets. "Basically, of the 14 or 15 milliion Americans who are current beneficiaries who are seniors and disabled who are below about 150 percent of poverty, in general, they're going to have somewhere upwards of 90 percent of their drug costs subsidized by this, including premiums ..." he said. Income for singles must be $12,000 a year or less, and, $16,000 for couples.
   Assets must be $6,000 - $8,000 or less to qualify, not including owning a home, Rosen said.
   A handout provided by Frist's press team outlines benefits to Tennesseans. Titled, The Medicare Prescription Drug, Improvement, and Modernization Act of 2003, What does it mean for Tennessee?, the handout claims:
   * All 873,247 Medicare beneficiaries in Tennessee will ahve access to a prescription drug benefit beginning January 2006.
   * 273,873 Tennesseans will have access to coverage they otherwise would not have.
   * In June 2004, Tennessee beneficiaries will be eligible for Medicare-approved prescription drug discount cards, which are estimated to achieve savings of 10 to 25 percent off the retail price of most drugs.
   * Low-income Tennesseans will receive a $600 annual subsidy in extra assistance on their prescription drug discount cards to help them purchase their medications. This represents a total of $2.6 million in low-income assistance to the state of Tennessee alone.
   * Beginning in 2006, the full drug benefit will be available to all Medicare beneficiaries. In exchange for a $35 monthly premium, seniors who are now paying full retail price for their prescription drugs will see their drug cost cut in half.
   * 357,843 Tennesseans who have limited savings and low icnomes will qualify for even more generous coverage, paying no premium and minimum copayments.
   * 72,673 additional low-income Tennesseans will qualify for reduced premiums, lower deductibles and coinsurance, and no gaps in coverage.
   * 198,786 Tennesseans who are eligible for both Medicare and Medicaid will receive their prescription drug coverage under Medicare, saving the state of Tennessee $6.9 million over eight years, according to estimates by the Bush Administration.