Bush Would Face Obstacles to Enacting Medicare Drug Benefit

Texas Gov. George W. Bush (R), if elected president, would likely face "significant challenges" from some Democrats in enacting a prescription drug benefit for seniors, CongressDaily reports. "I don't see it happening unless they're willing to take on the pharmaceutical companies," House Ways and Means health subcommittee ranking member Pete Stark (D-Calif.) said. Still, Senate Democrats may want to "reac[h] a deal," but only "on their [own] terms." An aide to Senate Health, Education, Labor and Pensions Committee ranking member Edward Kennedy (D-Mass.) said that Bush should "reach out to Democrats early and actively seek their input and advice." He added that Democrats do not have "a lot of willingness to compromise" unless Bush moves closer to them on key issues. Republicans remain "optimistic" that Democrats will want to pass legislation because many campaigned on the prescription drug coverage issue during the campaign.

During the past week, Bush has discussed the issue with congressional leaders -- including Sens. John Breaux (D-La.) and Bill Frist (R-Tenn.) -- to "gauge interest." A Frist aide said that the Tennessee senator would likely help a Bush administration to craft a plan. Bush spokesperson Ari Fleischer called prescription drug coverage a "top priority" and an important part of "modernizing Medicare," pointing out that the issue reflects "why we need to change the tone in Washington." In addition, he predicted that a Republican majority could pass a bill, "regardless of the margin."

In addition, the "sheer complexity" of Medicare reform may prevent Bush from developing a "viable" plan within a brief time frame. Former House Commerce Committee health counsel Howard Cohen said that Republicans should build on current legislation rather than embarking immediately on a "major Medicare overhaul." He said, "I'm optimistic about prescription drugs. The House passed the Thomas bill, and the Breaux-Frist bill is very similar. All you have to do is put more money in on the benefit side." He added that Congress should develop a program run by a new agency with a "hard (HCFA) fallback." Still, lawmakers appear to have "little consensus" on the issue. A House GOP leadership aide said that prescription drug coverage and Medicare reform is "not at all at a point of ripeness. Social Security (reform) is closer" (Fulton, CongressDaily, 12/11).