Pushing prescription drugs

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Republican congressional leaders are trying to collect enough votes to pass a prescription-drug bill. Over the weekend, Senate and House negotiators crafted a compromise that conferees found satisfactory. Whips do not have the votes necessary for passage yet, but a war room has been set up in the House. Every morning, congressmen and lobbyists will meet to thrash out tactics to get out the vote. It is an important fight.

House conservatives are the main targets for persuasion. While many conservatives are uncomfortable with the price tag, they should take comfort in the list of reforms in the package. For example, the law would approve a six-city experiment of direct competition between Medicare and private alternatives. Success of this pilot program could lead to substantial market-oriented reform of Medicare.

Cost-control measures in the legislation include a tiered premium system, mandatory competition among insurance plans and Health Savings Accounts that provide individual control to cover medical costs. Formerly known as Medical Savings Accounts, the measure has long been a priority for conservatives but was never within reach until now. Senate conferees went to great lengths to include the competition-based components to make the final bill attractive to the more conservative House conference.

Working overtime to push the bill is the AARP. Over three days this week, the group is spending $7 million in an advertising blitz to encourage passage. The AARP's 35 million members could prove convincing to many congressmen on the fence. On its Web site, the organization has a long list of mostly Democratic members who signed the AARP pledge to pass prescription drugs, many of whom do not support this AARP-backed plan, including Reps. Roscoe Bartlett and Jeb Hensarling, both Republicans.

A statement Monday by the Democratic-leaning AARP said the Republican legislation "represents an historic breakthrough and important milestone . . . The bill will provide prescription-drug coverage at little cost to those who need it most: people with low incomes, including those who depend on Social Security for all or most of their income. It will provide substantial relief for those with very high drug costs."

Off the record, liberal lobbyists criticize the role played by Sen. Teddy Kennedy, a generally shrewd legislative strategist. They note that Mr. Kennedy was fully engaged in cutting deals and helped craft the original Senate draft. Now, he is ripping into the conference report as dangerous and right-wing -- which seems disingenuous given its support by the AARP and Democratic Senate conferees Max Baucus and John Breaux. Many Democrats worry that their party will be punished in next year's election if it appears that seniors lost the drug entitlement because of partisan obstructionism.

The electoral risk of failing to pass a prescription-drug law applies to both parties. According to a USA Today/CNN/Gallup poll conducted over the weekend, 80 percent of Americans responded that they would be upset if Congress doesn't pass a prescription-drug benefit this year. Republicans would be blamed by a two-to-one margin. For conservatives, the stakes are even higher: This prescription-drug bill could offer the last chance to begin important market-based Medicare reform.