Bush Rx Drug Benefit Plan Would Face Several Hurdles
Although Texas Gov. George W. Bush (R) has indicated that enacting a prescription drug benefit for Medicare beneficiaries would be one of his main priorities if he becomes president, he would have to overcome a "morass of political and philosophical disputes" to reach his goal, the Wall Street Journal reports. A drug benefit was a recurrent theme in Bush's campaign, and he recently listed the issue as one of his "first goals" during his speech the night he was certified as the winner in Florida. His plan, as outlined during his campaign, consists of an immediate grant of $48 billion to states so they can "initiate or expand state-run programs for low-income seniors." After four years, Medicare would be "overhauled" and private insurers would offer "competing plans" in which the federal government would subsidize 25% of premiums for all seniors and 100% for low-income seniors. Catastrophic coverage would cap out-of-pocket expenses at $6,000 per year. The overall cost of the plan would total $148 billion over 10 years.
However, despite the "popularity" of a senior drug benefit in both parties, Bush will have difficulty pushing his plan through narrowly divided 107th Congress, the Journal reports. House Democrats believe that their prescription drug plan, which calls for a direct benefit through Medicare for all seniors, allowed them to gain seats in last month's elections. Republicans, on the other hand, received "unprecedented sums" from pharmaceutical companies, who oppose the Democrats' plan. In addition, Democrats object to Bush's state grants proposal because they believe it will help only low-income seniors, rather than all Medicare beneficiaries.
Democrats do not want states getting involved in federally run Medicare, and they contend that any relief would not be "immediate" because states would need time to implement programs "to dispense the benefits." Sen. John Breaux (D-La.), the Democrat "the Bush side looks to most for support," said, "My state wouldn't have the money to put up the matching rate. I don't think it will fly." And if Bush chooses to compromise with Democrats, he risks alienating his conservative supporters.
Many lawmakers and health care professionals believe that Bush needs to move quickly on the prescription drug benefit if he wants to pass any meaningful legislation. According to the Journal, if Bush becomes president, "he would likely have only a narrow window before the partisan maneuvering gets under way for the high-stakes 2002 congressional elections." The "short-term remedy" of state grants would likely be the focus of a Bush administration. Bush adviser Sen. Bill Frist (R-Tenn.) said, "I would advise doing the first step to immediately get some relief." Despite Democrats' objections, Len Nichols, a health care economist at the Urban Institute, believes the plan is politically viable. "I think a carefully structured proposal funneling money quickly to states for low income seniors would be difficult to oppose," he said, adding that a guarantee of eventual coverage for all Medicare beneficiaries would make the plan even more attractive. Still, others believe it will take time before a two-party consensus can be reached. Marty Corry, director of federal affairs at the American Association of Retired Persons, said, "Putting together a bipartisan drug bill, whether part of an overall Medicare reform or a freestanding bill, doesn't happen overnight. This is a very difficult area in which to legislate" (McGinley/Calmes, Wall Street Journal, 12/7).This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.