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Senate defeats bid to extend Medicare drug plan deadline

WASHINGTON -- The Senate rejected an effort by Democrats yesterday to give older Americans and the disabled more time to enroll in Medicare's prescription drug benefit.

Senator Bill Nelson, a Florida Democrat, offered an amendment to tax legislation that would have given Medicare beneficiaries until Dec. 31 to enroll without penalty. The current deadline is May 15.

The amendment also would have allowed people to switch their prescription drug coverage to another plan if they were unhappy with current coverage.

The amendment received a majority of votes, 52-to-45, but needed 60 to pass under Senate rules for measures concerning budgets and taxes. Nelson said his amendment was a chance for lawmakers to act on complaints they've heard from their constituents since the program began Jan. 1.

But Senator Charles Grassley, Republican of Iowa, said the legislation was unnecessary. He said passing a bill would only cause delays in solving problems that can be dealt with administratively by Health and Human Services Secretary Mike Leavitt.

At a hearing on the problem earlier yesterday, Nelson told fellow lawmakers of seeing elderly people weep as they described difficulties in filling their prescriptions.

Senator Hillary Rodham Clinton, Democrat of New York, said she was tired of hearing how so many people were signing up. Many people in the program already had coverage, she said.

''I for one believe we should scrap this and start over," Clinton said.

Republicans also said they had heard from people who have had difficulty filling prescriptions, or have been charged more than they should have been, but they told Mark McClellan, head of the Centers for Medicare and Medicaid Services, that the program should be fixed, not scrapped.

''It is nearly impossible to avoid startup challenges, but we now we must identify those individuals who are vulnerable and make certain that their needs are met," said Senator Elizabeth Dole, Republican of North Carolina.

McClellan said the government makes ''no excuses for the problems. They are important, they are ours to solve, and we are finding and fixing them."

The Bush administration had asked private insurers to supply older people with an additional 60-day supply of medicine in emergency cases. That will give beneficiaries more time to find alternative treatments when their plan will not cover a prescription or more time to file an appeal. Pharmacists had warned that the previous 30-day limit could pose significant problems for poor older people and the disabled.

The program is working for most people, McClellan said, and competition among the private plans was driving down costs.

Premiums will average about $25 a month, as opposed to the $37 projected when the program was approved. McClellan's agency estimates the program will cost about $678 billion over 10 years rather than about $730 billion.

Leavitt, in an earlier interview, said, ''We're seeing the cost of drugs come down in a rapid way because of an organized, competitive marketplace."

About 42 million older people and the disabled are eligible to participate in the drug benefit. They do so by enrolling in a private insurance plan. The benefit should lower drug costs for most participants because the government is subsidizing them.

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