Drug-card enrollment faces limits

WASHINGTON – The Bush administration is resisting calls from across the political spectrum to broaden automatic enrollment of poor people in the Medicare discount drug card program.

One reason cited by administration officials: They don’t want to limit people’s choice of cards, a key element in competition among drug cards that is supposed to help reduce prescription drug prices.

“We expect that by making the prices of most commonly prescribed drugs used by Medicare beneficiaries available to the public, the prices will actually drop due to competition,” Mark McClellan, administrator of the federal Centers for Medicare and Medicaid Services, told Congress in June.

McClellan said in a recent interview that the administration is halfway to its goal of 7.4 million people in the discount card program, a temporary measure before drug insurance under Medicare begins in 2006.

Yet two-thirds of the nearly 3.7 million people who now have cards had no choice. They either belong to an HMO that requires members to use its card or they are in a state prescription drug-assistance plan for the poor that won approval to sign up participants automatically.

There are roughly six dozen national and regional discount cards for which Medicare beneficiaries pay up to $30.