Delay in Senate Floor Debate on Medicare Prescription Drug Benefit Proposals Causes ‘Tension’
The Senate's effort to pass a Medicare prescription drug benefit stalled yesterday as Democrats and Republicans accused each other of "playing election-year politics," the Washington Times reports (Fagan, Washington Times, 7/17). With the outcome of the debate uncertain, "tensions flared" as Republicans criticized the way Senate Majority Leader Tom Daschle (D-S.D.) had "arranged the debate" over the competing drug proposals. At the same time, Democrats alleged that Republicans were "stalling" at the "behest of the drug industry," the New York Times reports (Pear, New York Times, 7/17). Over the past few days, Senate Republicans, Democrats and a "tripartisan" group of senators have unveiled new proposals to add a drug benefit to Medicare. However, none of the plans has the 60 votes needed to pass, and each side is "scrambling" to win support with public rallies, "one-on-one lobbying of colleagues" and closed negotiations (Dewar/Goldstein, Washington Post, 7/17). Although the Senate appears to be "fatally deadlocked," Daschle said a bill would pass. "If we don't do it in two weeks, we'll do it in three. If we don't do it in three, we'll do it in four. If we don't do it in four, we'll do it in five," he said (Fulton/Rovner, CongressDaily/AM, 7/17). "I realize that not to get it done would put the Senate in a bad light," he added (Washington Post, 7/17).
With the Senate Finance Committee unable to reach a consensus on competing Medicare prescription drug benefit bills, Daschle had planned to bring to the floor generic drug legislation, which senators would be able to amend with their prescription drug plans during debate. The generics bill would amend a provision in the 1984 Hatch-Waxman law that allows brand-name drug companies to receive an automatic 30-month patent extension from the FDA when they file a lawsuit against generic drug makers for alleged patent infringement. It also would prevent brand-name companies from paying generic manufacturers to keep their products off the market and would allow generic companies to legally challenge "frivolous patents," including "superficial changes" in a treatment's color or physical design intended only to "stifle competition." But Sen. Judd Gregg (R-N.H.) formally objected to moving the generics legislation to the floor, meaning Democrats must file a formal motion to proceed (California Healthline, 7/16). Gregg said Democrats had not kept their agreement to correct language in the bill regarding how the FDA will define when a generic drug is equivalent to a brand-name drug. Also, Gregg is seeking changes to a deadline for filing patent challenges. "There is a delay occurring because there continues to be a stonewalling on the corrections of those problems," Gregg said (Fulton/Rovner, CongressDaily, 7/16). The Senate is expected to vote today on a motion to bring the generics bill to the floor for debate (Washington Times, 7/17).
Meanwhile, Senate Finance Committee Chair Max Baucus (D-Mont.) said he is mediating negotiations among the sponsors of the various drug proposals. He said the "key sticking point" in negotiations is not the final cost of the benefit but how it will be delivered. Democrats want to add drug benefits to Medicare, but Republicans want private firms to handle the system. In addition, Baucus has indicated he would not markup the tripartisan bill, saying he does not want to "waste time because there's not 60 votes for it" (CongressDaily/AM, 7/17). The tripartisan group, which includes Sens. Charles Grassley (R-Iowa), Olympia Snowe (R- Maine), Orrin Hatch (R-Utah), John Breaux (D-La.) and James Jeffords (I-Vt.), has proposed a $330 billion, 10-year bill under which Medicare beneficiaries would pay a $35 monthly premium, and the government would cover 50% of seniors' annual out-of-pocket prescription drug costs up to $2,000 or $2,500, no costs between $2,000 or $2,500 and $3,700, 90% of costs that exceed $3,700 and 100% of costs that exceed $6,000. The leading Democratic bill, sponsored by Sens. Bob Graham (D-Fla.) and Zell Miller (D-Ga.), would establish a Medicare prescription drug benefit at an estimated cost of as much as $500 billion over eight years. Under the legislation, which has the support of many Democrats, seniors would pay a $25 monthly premium with no deductible, a $10 copayment for generic drugs and a $40 or $60 copayment for brand-name treatments. The government would cover 100% of seniors' annual out-of-pocket prescription drug costs that exceed $4,000. Low-income seniors would pay reduced premiums, and the bill would exempt Medicare beneficiaries with annual incomes less than 135% of the federal poverty level from premiums and copayments (California Healthline, 7/11).
With floor debate on the competing proposals on hold, Democrats yesterday linked the delay to the recent "crackdown on corporate corruption" and said pharmaceutical companies are "padding their profits at the expense of consumers," the Los Angeles Times reports. "What this debate is about is greed -- corporate greed," Sen. Edward Kennedy (D-Mass.) said. "Prescription drug legislation is going to be opposed by those that are profiteering," he added (Hook, Los Angeles Times, 7/17). Democrats said Republicans were creating a delay because pharmaceutical companies are opposed to legislation that would lower the cost of prescription drugs (Washington Times, 7/17). Daschle said Republicans were deliberately slowing the process in order to "blame the Democrats" (Washington Post, 7/17).
At the same time, Republicans accused Daschle of arranging the debate to ensure that the main Democratic drug proposal would fail so Democrats would have a "potent political issue" for the November elections. "This is politics, raw, pure and simple," Sen. Rick Santorum (R-Pa.) said. "This process was scripted for failure -- for a partisan issue in November and nothing more," he added (New York Times, 7/17). Republicans also criticized Daschle for allowing the drug proposal to come to the floor "without hearings or markups" by the Senate Finance Committee (Washington Times, 7/17).
NPR's "Morning Edition" today reported on how the current Medicare drug benefit deliberations may be "complicated by the ghost" of the 1988 Medicare Catastrophic Coverage Act (Rovner, "Morning Edition," NPR, 7/17). The law, which former President Reagan signed into law and then repealed in 1989 before it took effect, would have helped the 16% of seniors with the highest drug costs, covering 50% of the costs beyond a $550 deductible. Seniors would have paid $1.94 per month for the benefit (American Health Line, 11/1/2000). The law was repealed amid a "backlash" from seniors who were not pleased with the cost of its deductible and its income-based structure (California Healthline, 1/7). NPR reports that "memories of that debacle" are shaping the current debate, adding that Congress' "dilemma" is to attempt to provide seniors "with what they expect" from a Medicare drug benefit -- which could be "prohibitively expensive" -- while acknowledging that a "minimal" benefit might "cause the same sort of outrage" lawmakers experienced in 1989 ("Morning Edition," NPR, 7/17). The full segment will be available in RealPlayer Audio online after noon ET. Expanded NPR coverage of Medicare drug benefit proposals also is available online.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.