Congressional lawmakers urged federal health officials yesterday to automatically enroll low-income seniors in the new Medicare drug discount card so they can get a $600 annual subsidy to help pay their drug bills.

One week into the new program that has seen few people sign up, lawmakers and senior advocates worry that the one group who would benefit the most may be left out.

"That's sort of a no-brainer," Sen. Jeff Bingaman (D-N.M.), said of automatic enrollment.

Overall enrollment in the discount program has been slow and some glitches still have to be worked out, lawmakers say. About 3 million seniors have signed up, officials say. Of those, about 2.4 million were automatically enrolled because they belong to a Medicare managed care plan.

Federal health officials said they have been working with seven states that already have senior discount drug programs, including New York, to automatically enroll low-income participants. The move would boost enrollment by 400,000.

"We're definitely looking into this issue," Mark McClellan, head of the Centers for Medicare and Medicaid Services, told the Senate Finance Committee yesterday. "It does present some challenges."

McClellan said one hurdle is that states must first get approval from their legislatures to act on behalf of beneficiaries. New York officials recently approved such a move. Another concern is making sure states are willing and able to automatically enroll poor seniors.

Critics and supporters of the discount card agree that low-income seniors could benefit by getting the $600 subsidy. Eligible seniors include individuals with incomes less than $12,569 and $16,862 for a couple.

Federal officials and senior advocates have launched outreach efforts to low-income seniors, who traditionally have been slow to enroll in aid programs. "By waiting, they end up leaving a lot of money on the table," McClellan said.

Democrats called for officials to expand automatic enrollment efforts beyond the seven states.

Robert Hayes, president of the Medicare Rights Center in Manhattan, said states stand to benefit the most because some drugs costs for low-income seniors will be shifted to the federal government. But seniors could get extra help with such costs as co-pays.

Automatic enrollment would mean millions of poor seniors would be signed up, Hayes said. "At the end of the day, that's all that matters," he said.

Sen. Charles Grassley (R-Iowa), chairman of the Finance Committee, called the card an important first step and blasted critics, saying the program "has been the target of a deliberate campaign to discredit it and confuse seniors about how it works."

Democrats say seniors are confused and skeptical, and the low enrollment figures illustrate that. They also say there should be fewer than 73 cards.