What Congress created was a system where seniors would choose between competing private drug plans. States were given a big role in implementing Medicare's "Part D," however, and some are taking steps to drive seniors into certain drug plans.
At least nine states have authorized the designation of a few "preferred" plans. The idea is that beneficiaries could still opt into other plans of their choice. But in general these measures would auto-enroll people who did not want to make a decision themselves.
Surprisingly, the federal Centers for Medicare & Medicaid Services (CMS) is going along with this idea. They have signed off on preferred plan proposals in Massachusetts, Pennsylvania and Vermont. These arrangements are drawing very little media attention.
CMS is accepting the idea amid complaints from seniors that the dizzying array of plans is too confusing. Confusion may be keeping down enrollment in the program. If that continues, expect more states to try to designate preferred plans next year.
