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Aid Program for Recipients of Medicare Comes to End
By Robert Pear, The New York Time
October 16, 2005
About 192,000 Medicare beneficiaries with low incomes face a steep increase in costs because Congress has not renewed a program that paid their monthly premiums, the Bush administration said on Saturday.
"These are highly vulnerable beneficiaries," the administration said in an e-mail notice sent to Congress on Friday night. The notice said that legal authority for the program expired at the end of the fiscal year on Sept. 30. So the low-income beneficiaries, who are 65 and older or disabled, will have to pay the premiums that until now were paid for them by the federal government.
The basic Medicare premium, $78.20 a month, will rise to $88.50 in January. Premiums are normally deducted from Social Security checks.
"The administration has no authority to reinstate the program," the notice said. "Congress must act. The president's 2006 budget proposed a one-year extension of the program. Without a reinstatement of the program, these 192,000 beneficiaries will be individually responsible for the payment of their Medicare Part B premiums."
Under the program, the federal government can pay premiums for Medicare beneficiaries with incomes of $1,097 to $1,464 a month. That amounts to $13,164 to $17,568 annually. Beneficiaries are known as "qualifying individuals," and the program is often called the Q.I. program.
The administration said, "States are responsible for notifying beneficiaries that the Q.I. benefit has been terminated."
The House and the Senate have passed separate bills to reinstate the program. The cost, roughly $200 million a year, would be offset by denying federal payments under Medicaid and Medicare for Viagra and other drugs for erectile dysfunction.
Congress left Oct. 7 for a 10-day recess without resolving differences on this and other issues. The two houses disagree over parts of the legislation dealing with welfare benefits, unemployment insurance and programs to promote sexual abstinence.
Kevin W. Concannon, director of the Iowa Department of Human Services, said: "Congress just walked away and left a lot of poor people hanging. It's frustrating and disheartening. We hope Congress will extend the program, but there is no guarantee."
The federal Centers for Medicare and Medicaid Services told Congress that it had "received requests for information on how to begin terminating beneficiaries from the program from states such as Florida, Nevada and New York."
Howard J. Bedlin, vice president of the National Council on the Aging, a research and advocacy group, said: "It's hard to believe that Congress would cut off vulnerable seniors from the help they need at such a critical time. Medicare premiums have increased more than 50 percent in three years. Do we really want to have thousands of seniors no longer able to afford to see their doctors?"
Gary R. Karr, a spokesman for the Centers for Medicare and Medicaid Services, said, "We want Congress to renew the program."
If Congress does nothing, the agency told Congress, beneficiaries will have to pay Medicare premiums for October and subsequent months. Several months' premiums could be deducted at once from a person's Social Security check.
The agency said that if the Social Security Administration receives a list of names in November, "the beneficiary will see his or her December check reduced by $234.60" - the amount for October, November and December at $78.20 a month.
Congress is scheduled to reconvene on Monday. Proposals to reduce the federal budget deficit are high on the agenda. Republican leaders say they will work with the White House to cut $35 billion from projected spending on Medicaid and other benefit programs over five years.
But Senator Charles E. Grassley, the Iowa Republican who is chairman of the Finance Committee, said he would try to preserve aid for low-income Medicare beneficiaries because the program had "proved its value in helping those who live on the edge of poverty."
"Congress needs to act quickly to make sure this important benefit is not lost," Mr. Grassley said.
Senator Jeff Bingaman, Democrat of New Mexico, has introduced a bill that would permanently authorize aid for low-income people on Medicare.
"Congress should not be playing political hot potato with this issue every year," Mr. Bingaman said.
The Bush administration said the uncertainty about aid for low-income people could have "a significant impact on the Medicare prescription drug benefit" that becomes available on Jan. 1. People receiving such aid are deemed eligible for extra help with their drug costs.
But if the program no longer exists, the administration said, it will be "much harder to motivate these individuals" to sign up for drug plan.
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