Rx DRUG COSTS: More Details About Roth’s Plan Emerge

      As more details about Senate Finance Chair William Roth's (R- Del.) Medicare prescription drug plan leaked out Wednesday, some lawmakers expressed cautious praise, while complaints from some others "began to grow," CongressDaily/A.M. reports. Roth's plan combines a prescription drug benefit with other Medicare reforms. It calls for drug coverage to be available in an "enhanced option" under Medicare, which would include broader hospital coverage but higher premiums (Rovner, 7/13). Under the expanded option, which would not be part of the traditional fee-for-service Medicare plan, beneficiaries would pay 20% of the costs of home health care, laboratory test and skilled nursing facility services -- costs Medicare beneficiaries currently do not pay. In addition, seniors could pay up to a $500 deductible for the drug benefit (McGinley, Wall Street Journal, 7/13). USA Today reports that Roth outlined some details to fellow senators as a "starting point." After seniors pay a deductible, the government would pay up to 50% of their drug costs. For those with very high annual medication expenses, the government would pay up to 80% of drug costs. For seniors with incomes less than $12,525, the government would subsidize all or part of the premiums, deductibles and copayments. The Congressional Budget Office still must perform an analysis of the proposed plan before Roth will set the premium and deductible amounts (Welch, USA Today, 7/13).

What Are the Chances?
      President Clinton praised Roth's effort, saying, "I am pleased that there is growing momentum on Capitol Hill to provide a real Medicare prescription drug benefit, not a flawed insurance model." White House Press Secretary Joe Lockhart said that Roth's plan was "a sharp repudiation" of the GOP bill recently passed by the House. But some Democrats said they were concerned the proposal "would not provide the low-income elderly enough help in drug coverage." Sen. Kent Conrad (D-N.D.) said, "I have a serious problem with forcing seniors who need prescription drugs to leave Medicare as we know it." Sen. Richard Bryan (D-Nev.) added that seniors with very high drug costs would still have to contribute a "substantial share" for those costs. Conservative Senate Republicans "showed little enthusiasm" for the Roth plan, but "were circumspect in their comments," the New York Times reports. Sen. Phil Gramm (R-Texas), a member of the Senate Finance Committee, said the proposal's costs "could explode on us overnight." He suggested that instead of a national solution, Congress should give states $20 billion over the next five years to find solutions locally. Gramm added, "The politics of this issue are not as sweet as Bill Clinton thinks. There is not going to be a major expansion of Medicare this year" (Pear, 7/13). Considering all the skepticism, Sen. John Breaux (D-La.) said, "As it stands now, I don't think [Roth] has the votes to get it out of committee" (USA Today, 7/13). Still, Roth remained optimistic that the plan's details could be "worked out so that the Senate can vote on a prescription drug plan before Election Day."

Election Issue
      Prescription drug costs remain "at the center of several competitive" House and Senate races around the nation, the Washington Post reports, pointing to the contest between incumbent Sen. Slade Gorton (R-Wash.), Washington state Insurance Commissioner Deborah Senn (D) and former Rep. Maria Cantwell (D). Last week, about six dozen seniors protested at Gorton's Seattle office, saying they were "tired of busing to Canada" for cheaper drugs. Even though Gorton "slipped out the door moments before the seniors arrived," the Post reports that "there is ample evidence that he is hearing their complaints." In April, he introduced the "prescription drugs fairness act," which would force pharmaceutical companies to charge the same price for prescription drugs in America as they charge in Canada and Mexico. He has since used that act as a "platform to criticize drug companies," even though it has no co-sponsors and "little chance of passage." Gorton also has thrown his support behind the bill introduced by Sens. Bill Frist (R-Tenn.) and Breaux that would offer Medicare recipients a choice of private drug coverage. Even with Gorton's drug costs stances carefully laid out, his rivals have criticized his positions. Senn said, "This is all election-year posturing. This is an issue he has been nowhere on." Cantwell concurred, saying, "His record in the past hasn't reflected a great deal of urgency in dealing with this issue." Both Cantwell and Senn have made prescription drugs a part of their campaigns. Still, Washington state Republican Chair Don Benton said that "moves by congressional Republicans to back prescription drug coverage have boosted the chances of GOP candidates in the state." He added, "The Republicans are making a real effort to do something about the problem, and the Democrats want the problem to continue so they can have something to whine about on TV" (Vita, 7/13).