GOP Control of White House, Congress May Offer ‘Best Chance’ for Medicare Rx Drug Benefit
Republican control of the White House and Congress may offer the "best chance in decades" for passage of a Medicare prescription drug benefit, the Washington Post reports. According to lawmakers, pollsters and strategists in both parties, President Bush and Republican congressional candidates made promises on a prescription drug benefit in the 2002 election campaign and "raised expectations that the party will indeed act" on the issue before 2004. Republicans "rewrote the political equation largely by embracing" an issue that "typically accrues to the benefit of Democrats," Republican pollster Linda DiVall said. Although Republicans "effectively neutralized" the prescription drug benefit issue in the 2002 election, Democrats said that "it would be much more difficult for the GOP to live up to their promises," the Post reports. One congressional Democrat said, for example, that GOP efforts to pass a prescription drug benefit would likely fail because of differences between moderate and conservative Republicans over the cost of such a program. However, Robert Blendon, a health policy professor at Harvard University, said that Bush may force Republicans to resolve differences on the issue before the 2004 election. "They made a prime commitment to do something before 2004," he said (Connolly, Washington Post, 11/16).
CongressDaily/AM reports that Senate Republicans next year may use a special budget process called reconciliation to "limit the scope" of a Medicare prescription drug benefit bill and prevent a Democratic filibuster. Under reconciliation, lawmakers would establish the cost of the program in a budget resolution, a move that would eliminate the "60-vote hurdle" that prevented passage of a prescription drug benefit in the Senate earlier this year. The House passed a GOP-sponsored prescription drug benefit bill this summer, but the Democratic-controlled Senate failed four times to pass similar legislation. The Senate Finance Committee next year will likely draft prescription drug benefit legislation based on a "tripartisan" bill that failed earlier this year (Fulton, CongressDaily, 11/18). The bill -- sponsored by Sens. Charles Grassley (R-Iowa), who will likely assume the chair of the Senate Finance Committee next year; Orrin Hatch (R-Utah); Olympia Snowe (R-Maine); John Breaux (D-La.); and James Jeffords (I-Vt.) -- would cost $370 billion over 10 years. Under the legislation, Medicare beneficiaries would have to pay a $24 monthly premium and a $250 annual deductible, after which the federal government would cover 50% of their annual prescription drug costs up to $3,450. After Medicare beneficiaries spent $3,700 out-of-pocket, the government would cover 90% of their annual prescription drug costs (California Healthline, 11/11). Grassley said he would meet with Sen. Don Nickles (R-Okla.), who will likely assume the chair of the Senate Budget Committee next year, and other senators to discuss the reconciliation strategy. However, Senate rules require that bills considered under reconciliation must relate to revenue, "so provisions seen as nongermane could be challenged," CongressDaily/AM reports. Democrats also will likely oppose Republican efforts to pass a prescription drug benefit that relies on private insurers to provide coverage (CongressDaily/AM, 11/18).
Republicans also will likely address tax credits for the uninsured, malpractice tort reform and a "small-scale" patients' rights bill in the next Congress, the Post reports. "Two years from now, they'll have a list of health care items and something to check in each box," Blendon said, adding, "They're going to address these things, but they're going to address them in their way" (Connolly, Washington Post, 11/16). However, the future of a Medicare provider "giveback" bill remains "uncertain," the Miami Herald reports (Dorschner, Miami Herald, 11/17).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.