|The White House
President George W. Bush
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For Immediate Release
Office of the Press Secretary
June 15, 2005
Teleconference Briefing on the Medicare Outreach Campaign
Dr. Mark McClellan, Administrator for Centers for Medicare and Medicaid Services at HHS
5:06 P.M. EDT
MR. DUFFY: Thanks for joining on a short notice. We do have Dr. Mark McClellan, the Administrator for the Centers for Medicare and Medicaid Services at HHS that's going to be conducting a on-the-record conference call about the Medicare outreach campaign that the President will be kicking off tomorrow. With that, I'll just turn it over to Mark, and we'll have some times for questions.
DR. McCLELLAN: Thanks, Trent. Thanks all of you for joining this afternoon. I know you have deadlines coming up fast, so I'm just going to give you a brief overview of the President's events tomorrow and Friday.
The President will be launching our Medicare Covers America campaign. That's a campaign that will bring to bear resources of the federal government, partnering with state and local governments, with the private sector, with advocacy groups, with beneficiaries, and it will call on all Americans to help educate and enroll seniors in this important new coverage coming to Medicare.
The coverage that Medicare is providing as part of the Medicare Modernization Act is, as you know, about prescription drugs, but it's really about more than that. Medicare has added new benefits for preventive services this year, so that our preventive coverage is more in line with the recommendations of expert groups than ever before; we've added new support for beneficiaries with chronic illnesses, help them understand how they can prevent the complications of those illnesses; and of course with modern medicine, you can't keep people well, you can't have prevention-oriented health care without prescription drugs. So it is very important from the standpoint of giving seniors and people with a disability access to modern health care to make sure they understand the facts about Medicare's new coverage, and that they can make an informed and confident decision about it.
It's also important for millions of other Americans -- their adult children, the people who help seniors and people with a disability make their decisions about health care and their finances, and so many other important decisions today. It's about all Americans whose lives are touched by seniors and people with a disability, because this is the path for modern medicine for the future, towards more of an emphasis on prevention, towards diagnosing diseases early, managing chronic conditions to help people avoid their complications, and prescription drugs is an absolutely integral part of that.
Prevention-oriented care, though, is a partnership. Doctors can't do it alone, patients need help, and this is about a partnership effort to launch this new outreach campaign.
Many of you are familiar with the basic facts about the prescription drug coverage, but many seniors are not. This is coverage that will be available to everybody with Medicare, no matter how they get their coverage -- whether they have existing drug coverage today, how they pay for their medications today. Everyone with Medicare will be eligible for help from Medicare's new prescription drug coverage.
The drug plans are going to be available on time in every single part of the country. They're going to cover the full range of brand-name and generic drugs. It will make prescriptions available at neighborhood pharmacies and through mail order. Also, for Medicare beneficiaries with limited incomes, and not just beneficiaries who are very poor and qualify for Medicaid, the drug coverage is even more generous. For about a third of all the people on Medicare, they will get help that pays for, on average, 95 percent or more of all of their prescription drug costs.
So for the vast majority of people who are eligible for this extra help, they will get prescription drug coverage that has no premium, no deductible, no gaps in coverage, and co-pays of just a few dollars per prescription. These are people who have really been struggling between paying for their medicines and paying for other basic necessities, and now they're going to have comprehensive coverage, and more resources available to pay for everything else. And so this is something that matters not only to seniors, but it also matters to all the people whose lives they touch.
That's why we've launched this broad, national grassroots effort. This outreach effort includes not just federal agencies that touch seniors, with a lot of help from not just CMF, my agency, but the Administration on Aging, the Social Security Administration, many other parts of the federal government. It also includes partnerships with state and local governments -- for example: increased funding for state health insurance assistance programs that have local offices around the country, to give people face-to-face help to answer their questions and help them learn about the prescription drug coverage. It includes partnerships with pharmacists; it includes partnerships with other health professionals, and many organizations, including many advocacy groups that opposed the original Medicare law. But now that this benefit is coming on schedule, we want to make sure that people get the facts so they can take advantage of the important new help.
There are two broad phases for this grassroots national outreach campaign. One phase, starting now, involves making sure everyone is aware about what the drug coverage means for them. The Medicare drug coverage includes a lot of different features, because people get their prescription drugs in a lot of different ways and they have different needs and preferences. And the point of this campaign is to make sure that we can target the help personally to people. They don't need to know about every feature of the law; they need to know about the features that are most important to them so they can make an informed, confident decision.
The second -- also in this first phase of the outreach effort, we are starting early with reaching Medicare beneficiaries with limited incomes. This, historically, on every previous program, has been a hard population to reach, and that's why we started more than seven months before the benefit actually begins with helping them to enroll in that extra help, that comprehensive part of the Medicare prescription drug coverage.
The second part of this outreach and education campaign will come in the fall. That's when Medicare beneficiaries will be getting specific information, based on how they get their drugs today, based on where they live in the country, that will help them take advantage of the new coverage. It will help them make an informed decision.
And in the fall, there will be this continuing national and grassroots-level help with getting assistance with their prescription drug costs. This includes our 24/7 1-800-MEDICARE phone line. It includes face-to-face assistance from state health insurance assistance programs, from area agencies on aging, the local offices, the aging centers around the country. It includes the participation of all of the many outside groups that are joining this effort to educate seniors so they can take advantage of this very important next step in bringing Medicare up to date.
A lot of this grassroots and national outreach effort is underway already, involving the extra assistance. For example, the Social Security Administration has mailed out millions of letters to people who are likely to be eligible for the extra help to let them know about it. SSA has worked hard with many other agencies to make the application for this extra help as straightforward as possible. It's only four pages with 16 questions. That's in contrast to a typical Medicaid program application which runs more than 20 pages and also requires a lot of complicated attachments, like tax forms. None of that is needed here. It's one simple form.
More than a hundred groups have come together in the Access to Benefits Coalition to work together with the federal government to make sure lower-income beneficiaries are informed and, as they put it, "when in doubt, fill it out," sign up for this extra coverage. And groups that are a part of this effort include AARP, include Families USA, include many disease advocacy organizations, all with a strong, simple message that if you are eligible for this coverage, find out about it, fill out that application, and send it in so that you can take advantage of it next year.
We're going to build on these outreach efforts that we're already starting right now to make sure people can get the personalized support that they need to take advantage of these most important changes in the Medicare program in 40 years.
I'm going to stop there and see if there are any questions.
Q I may be the only question, but a parochial matter -- is your mother going to announce for governor?
MR. DUFFY: Oh please, Bob.
DR. McCLELLAN: You're on the wrong press call, Bob. (Laughter.)
Q I couldn't resist, so what's the answer?
MR. DUFFY: Next question.
DR. McCLELLAN: I think there may be some other press calls to handle that. I can probably give you the number if you hang on for a minute. (laughter.)
Q All right.
DR. McCLELLAN: Good question, though.
Q I tried.
Q I'm wondering if you can just tell me a little bit about what will be happening in Minnesota? As I understand it, there's going to be a roundtable discussion of some sort?
DR. McCLELLAN: There is going to be a roundtable discussion, Rob, but also, we're -- I think the President is going to spend a little time with one of the training programs that's going on right now. This is like programs that are taking place all over the country, for volunteers to learn about the important features of the Medicare drug coverage so that they can assist seniors and assist the family members of seniors in taking advantage of the new coverage.
So, for example, the Social Security Administration is training volunteers to let lower-income beneficiaries know about the extra assistance that's available to them and about what they need to do fill out that form that I mentioned, that form that's available right now to get -- to get them enrolled.
And the training also includes some of the details about the drug coverage that will be available to everybody on Medicare and that they can sign up for beginning in the fall, beginning November 15th. That includes information for people who have retiree coverage, about how the Medicare benefit will work with their coverage, it includes information for people with Medicare Advantage Health Plan coverage -- those are the coordinated care health plans in Medicare, and there are some right there in Minneapolis that provide extra coverage now, including some drug benefits now. They'll be providing even more drug coverage next year. It includes the information about the basic drug benefit for people who are struggling today because they don't have any prescription drug insurance. They'll find out about how they can get information this fall to choose a plan, and the other key features of the coverage.
So there will be a roundtable discussion with some of the seniors who will be finding out about and taking advantage of this important new prevention-oriented coverage next year, and there will also be some interaction with people who are involved in these training programs that are taking place all over the country right now.
Q And why is the President rolling this out in Minnesota?
DR. McCLELLAN: Well, the President has spent a lot of time all around the country over the last several years trying to get Medicare -- trying to make sure people know about the importance of bringing Medicare up to date, and now about information on the prescription drug coverage. And the state of Minnesota is one of many places around the country where there are millions -- where there are lots of seniors struggling with their drug costs today, and lots of seniors who need to know the facts, so they can make a confident decision about Medicare drug coverage.
MR. DUFFY: This is Trent Duffy in the White House. This is the first stop that the President is doing about Medicare, it certainly won't be the last. So he looks forward to going to Minnesota to talk about that.
Q Great, thank you.
MR. DUFFY: Sure.
Q Hi, Dr. McClellan. I have a question that's slightly off topic, not as much as the first one we had. But can you give us an update on the Medicaid Commission and how that's going?
DR. McCLELLAN: Just briefly, the Medicaid Commission is going forward. I think it's going to -- it will have bipartisan membership, it will make some important contributions to the ongoing discussions about how to make the Medicaid program sustainable. We'll have more to say about that soon.
MR. DUFFY: Any other Medicare-related calls?
Q Hillman asked my question. We care only about your mother today. (Laughter.)
DR. McCLELLAN: I'll pass that along.
Q We always care about your mother. I'll pass then, thanks.
DR. McCLELLAN: Thank you. I'll pass that along.
Q Hi, Dr. McClellan. I guess my main question is, is the focus right now on the low-income sign up, or is it on educating people about the basic benefit package, because you just got the bids in, and we don't really know what all the different options are going to look like at this point.
DR. McCLELLAN: Right, but seniors do have questions about the coverage. You know, some of them don't know that this is a benefit that's available for everyone, regardless of how they pay for their drugs today. And one of the things that we want to let everyone know right now, is that based on their own circumstances, what the Medicare benefit can mean for them, and how they can make a decision about it in the fall.
So, for example, people with retiree coverage today are asking questions about how Medicare is going to work with their coverage, and for them, if they're getting good coverage for retire -- through their retiree plan, Medicare can help pay for its cost, and they will be getting information in the fall from their retiree benefit plan manager about how they can continue their coverage with the new help from Medicare. For different kinds of people, they need different kinds of information.
So we want to get out some of the basic facts now about what's coming in the fall, so that people will be ready to make an informed decision, and so that family members and the people who help seniors know where they can go to get personal assistance with signing up for drug coverage.
We are also trying very hard to make sure everybody who is eligible for the extra help for the people with limited incomes in Medicare knows about it. And that's why we're starting so early. Literally millions of people who haven't been eligible for Medicaid, haven't had drug coverage before, really are struggling between paying for their drugs and paying for other basic necessities, can get comprehensive help starting next year. And if they fill out this four-page application, we will make sure they get comprehensive coverage next year.
Because this is such a hard population to reach, we are starting as early as possible with our enrollment efforts. And we've got, literally, hundreds of partners inside and outside of government in making that happen. And the main advice for them is, if you think he may be eligible for this extra help, fill out the application, fill parts of the application out and send it in, and we'll have somebody call you back to help you fill out the rest. But this is such an important new benefit -- according to Jim Firman, the head of the National Council of Organizations on Aging, this is the most important new benefit in Medicare in 40 years -- we don't want to miss anybody, and that's why we're starting so early.
Q I wonder if you can do a couple of things for me -- if you can put a dollar figure on the outreach effort, if you can give me some idea of how to separate the two phases -- is one more public relations, the second phase more direct contact with potential beneficiaries? And how much of this decision to mount a large outreach effort is driven by the fact that you had less than what you expected in terms of participation for the prescription drug card?
DR. McCLELLAN: Well, let me start with that last point, because that leads into the other questions. The prescription drug card now has close to 6.5 million people enrolled -- 6.5 million seniors and people with a disability, and the forecast would be around 7 million people enrolled by the end of the program. So we are pretty close to that expected level of enrollment, and independent studies that have looked at people's satisfaction with the card and satisfaction with the enrollment process show that it's very high. That means millions of seniors are saving billions of dollars on their drug costs right now.
But we did learn from this experience, and it told us how important it is to start early, to work with many different organizations that all have the same shared goal of helping seniors lower their drug costs effectively. And many of those same organizations are going to be partnering with us now. The Access to Benefits Coalition and the hundred groups that it represents have done their homework based on that experience to how we can make this outreach effort even more effective.
And it is tough. You know, when Medicaid started, when Food Stamps started, those programs had fewer than a quarter of the eligible people sign up in the whole first year of the program. So we've tried to learn from those lessons, as well, as to how we can make the enrollment process as straightforward as possible so we can get even more people helped.
Now the -- this is a major effort because this is a major public health program. We expect to spend several hundred million dollars, combined, on all of our outreach efforts over the coming years, and that includes not just our 1-800-MEDICARE number, not just any advertising that may be done, but also support for our Internet site at Medicare.gov. Most seniors don't go on the Internet themselves, but we found literally millions of people ended up signing up for the drug card online via getting help from some of these local organizations that we're partnering with, getting help from their children and grandchildren, and stuff like that.
We're also supporting community-based outreach efforts. I mentioned the state health insurance assistance programs. These have offices in most counties around the country to get face-to-face help to people. The local aging offices for the Administration on Aging all over the country provide help every day to seniors with getting assistance with their medical needs. They'll be participating and they're getting support, as well. The Social Security Administration is doing mailings and hosting and helping to host local outreach efforts all over the country. Look, health care is local, and all these outreach efforts are local, as well.
This effort and the money that we're spending comes directly from the funds that Congress appropriated specifically for this purpose. We were given a billion dollars by Congress for 2004 and 2005 to conduct our outreach activities and our implementation of the Medicare laws. So all the new systems that we've set up to provide the drug card and now the prescription drug coverage, as well as the preventive benefits, all of the new Medicare advantage health plans, all of that coming out of that billion dollars that was mandated by Congress.
So I would be -- see from the answer to this that it's not just a matter of PR-versus-on the ground help, it's really an integrated national grassroots strategy to make sure that people can get the facts that are relevant to them so they can make a confident decision about taking advantage of this new prevention-oriented help for Medicare.
Q Dr. McClellan, the question I have is, I wasn't clear on those letters that you mentioned that were going to be sent out -- millions of letters. Was that going to be in the second phase?
DR. McCLELLAN: No, there are mailings going on right now in phase one. There will also be mailings in phase two. Let me be a little bit more specific about that. For right now, we're focusing first on people with limited income, people who are struggling the most with their drug costs, and they can often be the hardest to reach with these programs. So the Social Security Administration has mailed out letters to millions -- or is in the process of mailing out letters, I should say. They started at the end of May, and that's going through July, letters going out to millions of Americans who -- that we think are likely to be eligible for this extra help, with that four-page application and a return pre-paid envelope in it, as well as numbers to call for help. We've also mailed people who have Medicaid drug coverage today, other very low-income individuals who are on Medicare and have Medicaid drug coverage, to tell them about the new comprehensive Medicare coverage that's coming.
In the fall, every single Medicare beneficiary is going to get the mailing of our booklet that we send out every year, called Medicare and You, that gives beneficiaries the information that they can use to understand and take advantage of the Medicare benefits that are available. And we put that out for public comment, had a lot of public discussion around it over the last few weeks. That's still ongoing now. We're getting further input from experts in and out of government, members of Congress as well. We're going to finalize that, and have that go out in the fall. So there are going to be mailings in each phase of this effort.
Q What about the applications that you mentioned, the four-page application? Where is that -- is that going to be sent in the mail or are you going to have to apply for it?
DR. McCLELLAN: Both ways. It's being sent out by SSA, by the Social Security Administration, right now to everybody who we've been able to identify we think is likely to be eligible. We've seen from Social Security's test mailings that a lot of those people respond. Now many of them who get the mailing will end up turning out to have income and assets that's too high to qualify, but a lot of the people who are eligible have been replying as we've linked the letters that go out to local grass roots education efforts. And we're going to continue to do that.
But people who think they may be eligible can also call Social Security to get an application directly. They can call 1-800-SSA-1213. And we're partnering -- that's another example of what we mean by this national grass roots campaign. We're partnering with more than 30,000 pharmacies around the country to hold events and to make applications available through the pharmacies. You know, pharmacists, every day, are seeing seniors who cannot pay for their medicines because they don't have drug coverage, especially those with limited incomes, and they are helping us get this application to the people who need it the most. So those are just some examples of how we're getting the application out.
Q Thanks. I just want to ask what you're doing differently this time around, compared to the prescription drug card sign-up that you did before. Are you doing more of this kind of partnering, or --
DR. McCLELLAN: We're doing a lot of things differently, and for -- there are two main reasons -- three main reasons. One is that we've got more time. The drug card was an immediate, temporary-help program for people that didn't have drug coverage and were really struggling with their drug costs, that went into effect quickly. Second, we're able to build on all of the partnerships that we've already developed, so that we can reach all different kinds of Medicare beneficiaries, not just those who were intended to be helped by the drug card. And third, as I said before, we've been able to learn from our experience together, our experience -- the groups that we partnered with before, their experience, about the drug card.
The result of that is that we are able to enlist help from many more parts of the federal government. I've talked about SSA and the Administration on Aging and other parts of the federal government that have had time and have been working closely with us to provide this kind of outreach effort. We're going to be able to build on the effective steps, what we've learned from the drug card experience and our partnerships with many outside groups.
One of the lessons, for example, that came out of that, was that we all need to be working together with some clear, factual messages. So the Access to Benefits Coalition, which is this coalition of more than a hundred organizations -- senior groups, patient advocacy groups, minority groups and other medical professional groups -- have put together one simple message, which is that if you think you may be eligible for this extra assistance, sign up. And they are all working together to get out that simple message, and we've got a lot more time to do it than we did with the drug card. That's why we're starting now to give people the facts and make sure they can take advantage of the new coverage when it starts next year.
Q Can I ask a follow up, or just a second question?
DR. McCLELLAN: Yes. Yes, sure.
Q The -- you said that there is a booklet that you're going to mail out in the fall, basically to all Medicare beneficiaries --
DR. McCLELLAN: Right.
Q And you're getting comment on that now?
DR. McCLELLAN: Right. That -- we started that comment process actually back in the spring. We had some early drafts that went out, got a lot of useful comments about how we can present the information more clearly. If I was going to summarize those comments, what they really tended to focus on was trying to make sure people who are in different situations in Medicare could get exactly the information they need.
So there are some people who have retiree coverage; they need a place to find out exactly what the new Medicare help means for strengthening retiree coverage. There are people who have Medicare advantage health plans -- these are the private health plans in Medicare -- they need to know how they can get the extra drug coverage through the plan they have now. There are people who don't have prescription drug coverage at all today; they need to know about the features of the plans and how they can get help in the fall with learning about the specific options that are available to them and making a good choice about how they can get -- how they can get the most out of new Medicare benefits.
So we've gotten a lot of constructive feedback on how to improve that Medicare and You handbook. It's a very important handbook this year with all the new coverage in Medicare. So people have been paying a lot of attention to it.
MR. DUFFY: Time for one more.
Q What are the reasons that somebody on Medicare would not want to apply for this?
DR. McCLELLAN: Well, one reason is that they don't know about it, and there are a lot of seniors today who don't know that the new Medicare drug benefit is help for everyone with Medicare. You don't have to have a low income. You can get extra help through your retiree coverage, through other coverage that you have today. And there's comprehensive help available for people with limited incomes.
Another reason is they may have misinformation. And so we want to make sure that we're working with a lot of these outside organizations early to get the facts out so that people will know where to turn in the fall to find out about the specific coverage options that are relevant to them and how they can take advantage and make a confident decision about using that coverage.
Q Then why not enroll everybody on Medicare automatically?
DR. McCLELLAN: Because the -- this is a very important part of the Medicare program today. This is a voluntary program and people need to make a decision. I don't want to see Medicare fall 40 years behind modern medicine ever again. And so we are starting a partnership with our beneficiaries to where they can choose the coverage that best meets their needs. So it's voluntary for them to sign up and it's very important for us to get the facts out to them so that they can make an informed decision.
Q How many people are on Medicare now?
DR. McCLELLAN: About 42 million beneficiaries.
Q And what is your latest estimate for the cost of the prescription drug program?
DR. McCLELLAN: There are no new cost estimates. The cost estimates that came out earlier this year were around from -- from the Medicare program -- around $500 billion for the first eight years, from 2006 to 2014. If you track that out further, the cost estimates are around $700 billion.
Just to put that in context, the reason that the costs are going up is that we have more people on Medicare using more prescription drugs. And that's what modern medicine ought to be about.
Right now in the -- or last year, when I took this job, Medicare was spending more than 95 percent of its dollars on the cause of health problems after they happen. We were not putting enough investment into preventive care, and not putting enough investment into prescription drugs that can prevent costly complications of diseases, like dialysis that occurs for people who don't have well-controlled diabetes, or heart surgery that occurs for people who don't have well-managed heart disease, and prescription drugs are absolutely essential to preventing those complications.
So we are reorienting Medicare spending to a prevention orientation. We'll still pay for those complications when they occur, but we want to switch the distribution of Medicare spending so that there's just as much emphasis on prevention, on preventing these costly complications in the first place.
Q Okay, thanks.
MR. DUFFY: I think that's all the time we have. If anyone has further questions, you can reach me here at 202-456-2580. Thanks again for calling on a late notice, and thank you Dr. McClellan. We'll see you all tomorrow.
DR. McCLELLAN: Thank you all.
END 5:36 P.M. EDT