Bush Unveils ‘Stopgap’ Coverage Measure for Medicare Rx Drugs
President Bush yesterday sent Congress a "stopgap" plan that would send billions of dollars to states to help provide prescription drug coverage for low-income Medicare beneficiaries, the New York Times reports. Bush's "immediate helping hand" proposal would provide full drug coverage for seniors earning incomes up to 135% of the federal poverty level -- $11,600 for individuals, $15,700 for couples -- and partial coverage for those earning incomes up to 175% of the federal poverty line -- $15,000 for individuals, and $15,700 to $20,300 for couples. In addition, the plan would offer "catastrophic coverage" for seniors spending more than $6,000 per year on out-of-pocket prescription costs. Although Bush has not released specific figures, the plan will likely cost about $48 billion over four years. Bush said that the proposal would offer "interim access to drug coverage" for about 9.5 million seniors until Congress approves "fundamental changes" to Medicare (Pear, New York Times, 1/30). "If they're going to drag their feet, if the members of Congress on both sides of the aisle don't feel the same urgency that I feel ... on Medicare reform, then I feel it's very important for us to have an immediate helping hand," Bush said (Curl, Washington Times, 1/30).
Members of Congress expressed a "distinct lack of enthusiasm" for Bush's proposal, warning that the plan would hamper efforts to overhaul Medicare (New York Times, 1/30). "We shouldn't settle for a prescription drug plan that stops halfway through. If we pass this measure now, it would take the pressure off Congress to ever produce a real permanent solution," Senate Minority Leader Tom Daschle (D-S.D.) said (Washington Times, 1/30). He added, "The 'helping hand' won't be extended for long" (Roth, Houston Chronicle, 1/29). Criticizing Bush's plan as "too narrow," Sen. Olympia Snowe (R-Maine) said, "The concern is, if we have a temporary program, we may never get any more on prescription drugs (Ornstein/Jackson, Dallas Morning News, 1/30). Rep. Tom Allen (D-Maine), called the plan "disappointing," adding, "Bush's flawed plan represents a missed opportunity to move forward on prescription drug coverage for all 39 million Medicare beneficiaries" (Fritz, St. Petersburg Times, 1/30). However, House Ways and Means Committee Chair Bill Thomas (R-Calif.) and Senate Finance Committee Chair Chuck Grassley (R-Iowa) "voic[ed] optimism" about a possible bipartisan compromise. "Prescription drugs with incremental changes in Medicare [is] a doable proposition," Grassley said, adding, "The thing the president's proposal does is keep the heat on Congress to do something" (Hutcheson et al., Philadelphia Inquirer, 1/30). Thomas added, "I think [Bush is] putting himself in a position of saying, 'This is my idea of dealing with this, what's yours?" (Lueck, Wall Street Journal 1/30.)
Top Democrats also voiced concern that Bush's proposal would "leave out" many seniors (Reuters/Investor's Business Daily, 1/30). Sen. John Breaux (D-La.), a congressional leader on Medicare, called Bush's proposal "sort of like a welfare program, which is not going to be received well by Democrats or Republicans, because the fact is all seniors should have drug coverage, not just poor ones" (Hutcheson et al., Detroit Free Press, 1/30). He added, "It's going to take just as long to implement this as it would to do the complete Medicare reform package" (Philadelphia Inquirer, 1/30). Calling the plan a "distraction and a waste of time," House Ways and Means health subcommittee ranking member Pete Stark (D-Calif.) said, "It should be buried, quickly and deeply as a bad idea" (Stark release, 1/29). Michael Siegel, a spokesperson for Sen. Max Baucus (D-Mont.) said, "It is encouraging that [drug coverage] is a priority. But it does not go far enough" (Lindlaw, AP/Owensboro Messenger-Inquirer, 1/30). Sen. Ted Kennedy (D-Mass.) added, "I'm concerned the proposal does too little and will take too long doing it. Senior citizens deserve more substantial protection under Medicare" (Heldt Powell, Boston Herald, 1/30). However, White House Press Secretary Ari Fleischer called Bush's proposal an "interim or transitional" step and said that the president remains "firmly committed" to broader Medicare reform (New York Times, 1/30). Signaling his support for a "more ambitious" drug benefit, Bush concluded, "If in fact what [Congress members are] saying is that they plan on expediting a Medicare reform that would include prescription drugs for all seniors, then all of a sudden I begin to say, 'Well, gosh, that may make sense'" (Welch/McQuillan, USA Today, 1/30).
Critics also question "the wisdom of giving block grants to states," with many lacking prescription drug programs for Medicare patients (Kiefer, Christian Science Monitor, 1/30). According to the Washington Times, 26 states have enacted such programs, while nearly all others will consider proposals in this year's legislative session (Washington Times, 1/30). Siegel said that the plan's "impact may not be immediate because in some states ... the infrastructure is not in place" (Investor's Business Daily, 1/30). Marilyn Moon, a health economist at the Urban Institute, added, "I think it's very difficult to convince states to gear up for a program that's potentially underfunded and going to be terminated." In addition, the National Governors Association, "dominated" by Republicans, opposed Bush's proposal, arguing that he "should not shift that responsibility or its costs to the states" (USA Today, 1/30).
Other health care groups have also attacked Bush's prescription drug coverage plan. Ron Pollack, executive director of Families USA, said, "[W]e think the structure of [Bush's] proposal will make [Medicare reform] more difficult to achieve" (Neikirk, Chicago Tribune/Ft. Lauderdale Sun-Sentinel, 1/30). Warning about the "substantial" need for a drug benefit for seniors "in the middle-income range," Tricia Smith, senior health care lobbyist for the AARP, said, "When you look at prescription drug costs that are easily running hundreds of dollars a month, that quickly erodes the level of income" (Lippman, Atlanta Journal-Constitution, 1/30). AARP Legislative Director John Rother said, "The danger of something like this is it can be looked at as papering over the problem," while reforming Medicare "would help more seniors than this and would probably do it just as quickly" (Wall Street Journal, 1/30). He added, "The real issue here is a voluntary affordable drug benefit that is available to all seniors and disabled, and that's the best and most efficient way to do this job" (Rubin/Gerstenzang, Los Angeles Times, 1/30). However, Health Insurance Association of America President Chip Kahn praised Bush's plan, arguing that the proposal would help seniors "by building upon the framework of successful programs already in place in more than half the states." He added, "We also hope that his leadership on this issue will lead to swift action by the Congress" (HIAA release, 1/29). For more coverage on Bush's drug coverage plan, listen to an NPR "All Things Considered" report at http://search.npr.org/cf/cmn/cmnpd01fm.cfm?PrgDate=01/29/2001&PrgID=2. Note: You must have RealPlayer to listen to the report.