The number illustrates what former Utah Gov. Mike Leavitt says will be his toughest task as secretary of Health and Human Services - getting the prescription drug program for America's seniors running by 2006.

The Senate Finance Committee is expected to approve Leavitt's nomination for that post today and he could be confirmed by the full Senate by the end of the week.

The $534 billion prescription drug benefit is the cornerstone of the Medicare Modernization Act signed by President Bush in December 2003. It seeks to provide prescription coverage to an estimated 14.5 million seniors who either lack prescription drug coverage or are inadequately covered.

The first step in implementing the program was registering seniors for drug discount cards, a temporary program until the full drug benefits take effect in January 2006. But so far, 6 million seniors, or about 41 percent of those eligible, have registered for the program, about 23 percent below the department's goal of enrolling 7.4 million.

Just 18,190 Utah seniors have signed up for the program. At least 56,000 are eligible.

If confirmed, Leavitt would have a matter of months to get the system ironed out so seniors can begin registering for the permanent, and more complicated, prescription drug benefit in November.

"I have no illusions about the size of the task. It is immense," Leavitt told the Senate Finance Committee in testimony last week. "But I recognize that the president and the Congress made a solemn commitment to America's seniors."

Leavitt provided the Finance Committee with the new drug card enrollment figures in response to a written inquiry.

"One of the things the drug discount program shows is it's going to be very hard to get the enrollment in the drug benefit program that [the department] would like," said Dee Mahan, deputy director of health policy for Families USA, a health-care policy organization.

She said the permanent program will be more complex. Last week, the department issued 1,200 pages of regulations for the program with more to come. Mahan said it's going to take a gigantic education and outreach effort to make sure seniors understand the changes on the way.

"The job that they did on the discount card is not very encouraging," said Mahan.

The discount card enrollment figures were even more disappointing for poor seniors who would be eligible for $600 a year in prescription aid. About 1.6 million low-income seniors signed up for cards, barely a third of the 4.5 million expected.

Officials are concerned about the shortfall, said Peter Ashkenaz, spokesman for the Department of Health and Human Services. "We are working closely with local organizations through the Administration on Aging and the Access to Benefits coalition to reach these low-income individuals," he said.

Leavitt also will be under pressure to keep costs in check. When Congress passed the drug benefit, it had an estimated cost of $400 billion. Now the price tag is estimated at $534 billion, an increase some members say is unacceptable.