Former Federal Officials Raise Concerns About Medicare Prescription Drug Benefit

Implementing a Medicare prescription drug benefit would be difficult, regardless of how many beneficiaries would be eligible for it, Dan Crippen, former Congressional Budget Office director, and Bruce Vladeck, former administrator of CMS, then known as HCFA, told members of the House Energy and Commerce Subcommittee on Health yesterday, CongressDaily reports. Considering that the baby boom generation is expected to double the Medicare population from 40 million to 80 million by 2030, a universal drug benefit would "greatly increase federal expenditures and likely place a greater burden on our kids and grandchildren," Crippen said. He added that even without a drug benefit, Medicare, Medicaid and Social Security will consume the equivalent of "every fifth car, every fifth shirt, every fifth loaf of bread." Even limiting a drug benefit to Medicare beneficiaries with low annual incomes would not be as simple as it seems, Vladeck said. "Neither CMS nor the Social Security Administration maintains any income information on beneficiaries, other than that obtained from sample surveys," Vladeck said. He added that "any prescription drug benefit in which premiums, coinsurance or benefits vary by income will require creation of an entirely new administrative apparatus or reliance on existing state Medicaid agencies or ... other state agencies that do income determinations for state-operated pharmaceutical assistance plans" (Rovner, CongressDaily, 4/8).

House and Senate members are continuing to prepare their versions of a Medicare drug benefit, CongressDaily/AM reports. Senate Majority Leader Bill Frist (R-Tenn.) wants to schedule a vote on a Medicare reform bill that includes a drug benefit in June and has been holding "leadership-level" meetings two or three times a week to gather support for President Bush's Medicare reform framework. In addition, Sen. Edward Kennedy (D-Mass.) has been working with the Democratic Caucus on a Medicare bill that is more expensive than the $400 billion allotted for Medicare reform in either chamber's version of the fiscal year 2004 budget resolution. In the House, the Ways and Means Committee will hold a full committee hearing today that will serve as a "launch pad" for starting Medicare drug benefit and reform efforts, a spokesperson for committee Chair Bill Thomas (R-Calif.) said. Also in the House, some moderate Democrats are pushing a $367 billion Medicare bill that would give a drug discount card to all beneficiaries in Medicare Part B and would provide additional benefits to beneficiaries with incomes below 200% of the federal poverty level and those with drug costs that exceed $4,000 annually. Other lawmakers are working on legislation that would address rising drug costs. Rep. Dan Burton (R-Ind.) has proposed permitting people in the United States to reimport prescription drugs from Canada, where prices are often lower. Further, Sens. John McCain (R-Ariz.) and Charles Schumer (D-N.Y.) are pushing legislation that would make it easier to for generic drug makers to bring their products to market (Heil, CongressDaily/AM, 4/9).