Officials Cite Significant Rise In Coverage

Hours after the deadline for older Americans to sign up for Medicare drug benefits, President Bush's top health advisers yesterday rushed out a preliminary tally that they said shows 90 percent of the 42.5 million eligible people have federal or other kinds of coverage for medicine -- including at least 1 million who enrolled during a final blitz in the past week.

Health and Human Services Secretary Mike Leavitt announced that, based on "very good estimates," 38 million elderly and disabled people have gotten drug coverage through the new Medicare benefit, an employer or another government health program.

Leavitt praised the six-month enrollment process, which ended at midnight Monday, as "a remarkable American moment . . . sort of a de Toqueville moment." Mark B. McClellan, administrator of the Centers for Medicare and Medicaid Services, said the program is a "historic success."

The superlatives and swift release of the incomplete figures were an attempt by the administration to reshape the image of the fledgling drug program, which has been dogged by widespread complaints and persistent partisan fighting.

Even as the administration declared victory, key senators yesterday tried to rewrite the rules for Medicare patients who missed the deadline.

Senate Finance Committee Chairman Charles E. Grassley (R-Iowa) introduced legislation to eliminate a financial penalty for Medicare patients who wait to enroll until the next signup period, which is late this year.

"We're dealing with a whole brand-new program," Grassley said. "We want to give people an opportunity to get acquainted with it."

He said the change would cost about $1.7 billion over five years, because of the penalties the government would not collect, and he predicted that the Senate could approve it as early as this week.

In the House, the Ways and Means health subcommittee chairman, Rep. Nancy L. Johnson (R-Conn.), has said she favors such a change. But Majority Leader John A. Boehner (R-Ohio) said the House would first take a broader look at how the drug program is working.

Administration officials have opposed extending the deadline, as Democrats have urged, or waiving the penalty. Yesterday, they sidestepped questions about the penalty, now that the deadline has passed. "We'll take a good, careful look at that," White House press secretary Tony Snow said.

Leavitt said, "That would be Congress's decision." McClellan, however, echoed the concern of House conservatives about making the program more expensive, and Leavitt urged lawmakers to wait until enrollment figures become final in perhaps a week to see how many people would be affected.

He and McClellan showed no similar reluctance in touting figures that they said prove the program is succeeding. HHS is using a broad definition of how many people are being helped, counting people who have started to get the new benefit along with those who earlier got drug coverage through other means.

By that definition, Leavitt said, an estimated 4.5 million people on Medicare still lack drug coverage, and about two-thirds of them would qualify for low-income subsidies.

According to HHS figures from last week, 20.7 million people are getting help directly through the new program. They have signed up for private drug insurance policies, are getting coverage through Medicare HMOs or were automatically enrolled because they are poor enough that they also qualify for Medicaid.

Yesterday, McClellan said that 872,000 people signed up last week, and that an unknown number enrolled during the weekend or on Monday.

The agency's figures have drawn criticism from Democrats and some patient advocacy groups, which say the agency is counting some people more than once. And some recent surveys of older Americans have found relatively large proportions saying they do not plan to sign up.

Leavitt rejected the criticism. "I'm confident this is the best number in town," he said. "No one would even be in a position to have a better number."