I thank the Chairman for holding this hearing on Medicare Prescription Drug Cards and I welcome Dr. McClellan to the Committee. I am anxious to hear Dr. McClellan's testimony explaining how these cards are going to work.

I have been concerned about these cards, and the private companies that run them, since the Bush Administration first proposed them two years ago. Thus far, I have seen little to allay my concerns.

Let me be clear. It is not that I find these cards evil. I do, however, find them often misleading, consistently confusing, and of dubious workability. And if they don't work, this has serious implications for Medicare and the seniors who depend on it. The confusion and difficulty produced so far could undermine the longstanding trust that seniors have in Medicare.

First, there are 73 cards to choose from -- each one offering something different that changes constantly. I know we all want choice, but how can anyone, especially someone who is ill, make a good decision under these circumstances?

Second, I have yet to see convincing evidence that the savings from these cards justify the difficulty and confusion for seniors and the expense to Medicare and taxpayers. The amount of discounts seniors are getting with these new cards doesn't appear to be any better than what is available in the market today. The majority of pharmacies already give cash-paying seniors a 10 percent discount at the register. Places like drugstore.com or Costco have better or comparable discounts, and the Veterans Administration has the best prices around.

I direct your attention to this CMS chart -- which has since been recalled -- showing how prices under various discount cards compared to Canadian prices and prices that the Veterans Administration gets. Prices in the Federal Supply Schedule were $300 lower than the most generous card listed on the CMS table for a general basket of drugs commonly used by the elderly. But this Administration fought bitterly to prevent seniors from getting similar discounts.

Third, confusion and bureaucratic reluctance are hindering the one bright spot -- the $600 for low-income seniors. Unfortunately, the people eligible for this money are the most likely to be intimidated by the confusing process. CMS has not done what is needed to assure all eligible beneficiaries receive this subsidy. In fact, there are predictions now that only 65 percent of those eligible will enroll in the subsidy. That is unacceptable.

CMS could automatically enroll low-income seniors who are currently in the Medicare Savings Program into the discount card subsidy. It is doing so for seniors in State Drug Assistance Programs. CMS has the information to enroll these other low-income seniors who are also eligible for the $600, but has declined thus far. I and other Democratic Members are introducing a bill to automatically enroll all low-income seniors. It is the least we should do.

I look forward to the testimony of our witnesses, and to future hearings on the implementation of the entire Medicare drug experiment.