Republicans, Democrats Agree Bush’s $190 Billion Prescription Drug Benefit Proposal Spends ‘Too Little Money’
Congressional Democrats and Republicans are "in rare agreement" that President Bush's $190 billion proposal to provide a Medicare prescription drug benefit spends "too little money" to solve "one of the main problems in the nation's health care system," the Washington Post reports. Both parties are recommending Medicare drug subsidies that are "far beyond" the president's proposal, with some Senate and House Democrats pushing a plan that would cost more than $700 billion. The main sticking points between Congress and the White House include: how many beneficiaries should have a drug benefit; when that benefit should begin; and how much the government can afford to spend on it, the Post reports. While administration officials and some legislators believe Congress will approve a drug benefit this year, Sen. John Breaux (D-La.), "usually one of the Senate's optimists" about Medicare reform, said that the odds of establishing such a benefit this year are "probably less than 50-50" (Goldstein, Washington Post, 2/26).
Bush announced his most recent proposal for broad-scale Medicare reform earlier this month. That plan calls for $190 billion in spending over 10 years. Of this amount, $77 billion would go to states to provide prescription drug coverage to seniors through Medicaid. The program would cover seniors up to 150% of the federal poverty level -- about $12,880 for singles and $17,400 for couples. An "unspecified amount" would also go to add a limited drug benefit to Medicare and add two more options for Medi-Gap supplemental policies (California Healthline, 2/5). This plan is in contrast to Bush's "immediate helping hand" proposal announced last winter, which would have spent about $48 million over four years to provide full drug coverage for seniors earning incomes up to 135% of the federal poverty level and partial coverage for those earning incomes up to 175% of poverty. That plan also would have offered "catastrophic coverage" for seniors spending more than $6,000 per year on out-of-pocket prescription costs (California Healthline, 1/30/01). Lawmakers last year were "unreceptive" to the plan and feared it would "drain momentum" from broader congressional efforts to reform Medicare. Mitch Daniels, director of the Office of Management and Budget, said, "The president has had multiple initiatives. ... He's the only one who really has been acting to try to address this problem."
The Post reports that although Senate Democrats agree that Bush's proposal is inadequate, they are divided over the correct course of action. Senate Majority Leader Tom Daschle (D-S.D.) and a "few of the party's other leaders on health care" are considering a 10-year plan that costs $725 billion and would subsidize drug costs for all Medicare beneficiaries. But Senate Budget Committee Chair Kent Conrad (D-N.D.) favors a "means-tested" drug benefit that would only be available for low-income beneficiaries or those with "particularly large" drug costs. Republicans are "somewhat more united," the Post reports. House Speaker J. Dennis Hastert (R-Ill.) and other Senate Republicans support a 10-year, at least $300 billion prescription benefit plan that would cover "some" Medicare beneficiaries. Republican leaders agree with the Bush administration that a drug benefit should start by covering Medicare beneficiaries with the least ability to pay for medicine. In addition, some congressional Republicans want to pass laws that would implement drug benefits in three years, when the White House predicts budget surpluses will return (Washington Post, 2/26).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.