House Democrats to Announce $750B Medicare Prescription Drug Benefit Plan
As expected, Senate Democrats unveiled a Medicare prescription drug benefit plan yesterday, while their House counterparts prepared to release their own proposal today, CongressDaily/AM reports. The House Democratic plan is expected to exceed the cost of both the $350 billion, 10-year House Republican plan and the $400 billion to $500 billion, eight-year Senate Democratic plan, coming in at between $750 billion and $800 billion over 10 years (Rovner, CongressDaily/AM, 6/13). House Democrats initially had planned to wait to announce their proposal until House Republicans formally released their plan, but "internal pressure from the Democratic caucus to go on the offensive led to the earlier unveiling schedule," according to aides. The House Democratic plan is expected to call for a $100 deductible and a $25 monthly premium, with the government covering 80% of seniors' drug costs up to $2,000 and 100% above that figure. "We've got to do everything we can" to approve a Medicare drug benefit, House Minority Leader Dick Gephardt (D-Mo.) said, adding, "We've been talking about it for four years now."
Latest drafts of the House GOP plan call for a $250 deductible and a $35 premium, with the government covering 80% of drug costs up to $1,000, 50% up to $2,000 and no coverage between $2,000 and $4,500. A 100% "catastrophic coverage" benefit would kick in after $4,500 (Fulton/Wegner, CongressDaily, 6/12). The plan would enlist private insurers to provide the coverage (California Healthline, 5/17). GOP aides said that House Republicans would likely introduce their Medicare reform package, which includes the prescription drug benefit, next Tuesday, with mark up by the House Ways and Means and Energy and Commerce committees coming next Thursday and a floor vote expected the following week (CongressDaily, 6/12). The respective chairs of those committees, Reps. Bill Thomas (R-Calif.) and Billy Tauzin (R-La.), are reportedly divided over the degree of Medicare structural reform that the package may contain, and the two panels may mark up "somewhat different bills." Thomas, who favors greater reform, said the bill coming out of his committee will be a "Medicare modernization bill with a prescription drug benefit and provider [payment] updates" (CongressDaily/AM, 6/13).
Meanwhile, Senate Democrats said they are confident that their drug benefit can be enacted this year despite the divergent approaches being proposed, Cox News/Washington Times reports. "We can and we will enact legislation this year," Sen. Bob Graham (D-Fla.), a co-sponsor of the bill, said, adding, "None of us are here because we buy into the conventional wisdom that nothing significant will be accomplished in an election year or a year which is dominated by a war on terrorism." Under the plan, which also has the support of Senate Majority Leader Tom Daschle (D-S.D.), Majority Whip Harry Reid (D-Nev.) and Sens. Edward Kennedy (D-Mass.) and Zell Miller (D-Ga.), beneficiaries would pay a $25 monthly premium with no deductible, a $10 copayment for generic drugs and a $40 copay for brand-name drugs, and the government would cover all drug costs more than $4,000. The plan also calls for reduced or no premiums or copays for low-income beneficiaries (Lipman, Cox News/Washington Times, 6/13). Graham said focus groups have shown that seniors prefer copays to coinsurance, and that his plan's use of a tiered drug benefit could produce savings by encouraging seniors to seek cheaper generic drugs (CongressDaily/AM, 6/13). But Thomas criticized Senate Democrats' proposal because it would expire in 2010 and require congressional reauthorization after that date. "The Senate has essentially offered a demonstration project when the need to provide prescription drug coverage for seniors has already been clearly and repeatedly established. It is a cruel hoax for the Senate to offer needed medicine only to take it away later," he said (Cox News/Washington Times, 6/13).
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