House GOP trolls for votes on Medicare drug bill

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House Republican leaders stepped up lobbying efforts on the Medicare prescription-drug bill last week, holding meetings with rank-and-file Republicans to gauge support for the bill and count votes.

Negotiators in the House and Senate are hoping early this week to finalize a bill that would reform Medicare and create a new prescription-drug benefit for seniors. Republican leaders are working to include key reforms that House Republicans are demanding, such as requiring Medicare to compete directly against private plans starting in 2010 and creating a mechanism to contain Medicare costs.

Senate Democrats strongly oppose these demands, and negotiators have pitched variations on the theme to see which will gain the most support.

It appears that Republican negotiators might be aiming to produce a bill that can pass the House and garner a bare majority of 51 votes in the Senate.

"That is one possibility," said a House Republican leadership aide. "But we're still trying to get Democratic votes."

Leaders met last week with some of the 19 Republicans who voted against the House Medicare bill. They also targeted 13 Republicans who supported the House bill but then signed a letter saying they will vote against the final bill unless it contains reforms such as the 2010 competition provision, cost containment and creation of more Health Savings Accounts.

Rep. Mike Pence, Indiana Republican, who voted against the House Medicare bill and has been a vocal opponent of a costly new drug entitlement, met Thursday with House Majority Whip Roy Blunt of Missouri and last week spoke to House Majority Leader Tom Delay of Texas. He said he was told that the bill emerging from conference has more Medicare reform than the House-passed bill -- a pitch other Republicans also heard.

Rep. Jim Ryun, Kansas Republican and another "no" vote on the House Medicare bill, met with Mr. Blunt last week as well, but is undecided.

Mr. Pence, who remains skeptical, said leaders pointed to new provisions in the final bill, such as requiring wealthier seniors to pay higher premiums for doctor visits under Medicare and providing a cost-containment mechanism.

Rep. Jim DeMint, a South Carolina Republican who voted no, also spoke with leaders and is "cautiously optimistic" that he might vote for the final bill, judging by the reforms Republicans are getting.

Rep. Sue Myrick, North Carolina Republican, heads a caucus of House conservatives called the Republican Study Committee and was one of the 13 Republicans to sign the letter. She met with Mr. Delay on Thursday and also has met with Mr. Blunt recently to discuss what conservatives could support.

"It's going in a good direction," she said of the bill, even though she hadn't seen final bill language in some areas, such as the 2010 competition.

Rep. Tom Feeney, Florida Republican and one of the 13, also met with Mr. DeLay and said he came away pleased that Republicans are going to get "really good language" in three or four areas, and less than they want in one or two.

On Nov. 6, Republican leaders got major help in selling the bill to conservatives when a broad coalition of outside conservative groups, including the Club for Growth and Family Research Council, told House leaders that they'll support the final bill because it contains the Health Savings Accounts provision.

Notably, however, leaders recently haven't targeted conservative House Democrats known as the Blue Dog Coalition, said Rep. Collin C. Peterson, a Minnesota Democrat who voted for the House bill along with eight other Blue Dogs. Mr. Peterson warned that although he strongly supports provisions in the final bill that would boost support for rural doctors and hospitals, he won't vote for a Republican bill that's destined to die in the Senate.

Leaders also have to decide whether to include language allowing the importation of drugs from other countries, where they are sold for less. Missouri Republican Rep. JoAnn Emerson, a key proponent of drug importation, said at least 11 members will vote against the bill if it has no importation or a watered-down version.