Rural Areas Need Drug Benefit

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Rural Areas Need Drug Benefit

By JACK SULLIVAN

Associated Press, September 1, 2003

WASHINGTON - A Medicare drug benefit is most needed in rural areas, where recipients are twice as likely as those in the city to lack any such coverage, according to a report prepared for a think-tank run by President Clinton's former chief of staff.

The report by the Center for American Progress was released as Congress prepares to hammer out differences in House and Senate bills on new Medicare legislation.

Center president and founder John Podesta said the report "tried to point out where improvements are really needed in both bills to make the legislation fair and equitable in rural America."

The report found that fewer Medicare recipients in rural areas have drug coverage through private insurance plans or benefits provided by former employers than those in cities. It also found that rural patients spend about 25 percent more on prescription drugs than those in cities.

The recommendations included keeping House provisions that extend the benefits to low-income seniors who may also be eligible for Medicaid, the federal health program for the poor. The Senate version does not offer the benefit to Medicare recipients who are also eligible for Medicaid.

The report also calls for a stable system for administering the plan in rural areas, where private companies may come and go. At a minimum, the report recommends keeping Senate provisions that create a government "fallback" for rural areas where there are no private insurers offering the plans.

Finally, the report recommends allocating spending so rural recipients don't pay higher costs that support managed-care plans available in cities but not where they live. "It's kind of a double hit for rural seniors," said Jeanne Lambrew, a George Washington University researcher who was one of the report's authors.

The rural provisions have the support of Senate Finance Committee Chairman Charles Grassley, R-Iowa, who pulled his aides from meetings with House Republican staff last week because he was concerned the provisions weren't getting the attention they deserved, spokeswoman Jill Kozeny said.

Montana Sen. Max Baucus, the top Democrat on the Finance Committee, drafted much of the Senate proposal with Grassley. Both senators represent largely rural states.

Baucus said he agreed with many of the report's recommendations, including how it favored the House plan to offer Medicare benefits to people eligible for Medicaid.

That proposal was kept out of the Senate plan because "it just saved money, essentially," Baucus said. "But I think the House policy is the better policy."

Baucus said he expects rural needs to be addressed in the final Medicare bill. "While this bill may not be perfect, at least it's better than the status quo - by far, for most people."

Podesta said the report has no partisan aim.

"I think there will be people on both sides of the aisle who will wish that the analysis had not been done, and I think there will be people on both sides of the aisle who will welcome it," Podesta said.