- The Washington Times - Sunday, March 23, 2003

The onus is on Republicans to get a prescription drug benefit into law, especially heading into the next election, according to observers in both parties.
"The pressure on politicians will be very intense," said Robert D. Reischauer, president of the Urban Institute and a former director of the Congressional Budget Office (CBO).
"And Republicans will be concerned that Democrats will use a failure to provide a prescription drug benefit in the elections, saying that Republicans had control of the White House and both chambers of Congress and could not get this enacted."
Sen. John B. Breaux, Louisiana Democrat, said "the pressure is on [Republicans] to get it through." A Senate Democratic aide said President Bush "has staked a lot on this."
Republicans agreed there is some pressure but said political ramifications will depend on how the prescription drug debate goes.
Sen. George F. Allen, Virginia Republican and chairman of the National Republican Senatorial Committee, noted that "if Democrats obstructed or filibustered" the Republican plan, they would be blamed for its failure. Mr. Breaux agreed with this assessment.
Mr. Allen added, however, "We're not looking to blame, we're trying to get things done."
Lawmakers on both sides are optimistic that a proposal can be passed by Congress soon.
"I think you'll definitely see a drug benefit in place before the next election, and I think it will be done this year," said Sen. Judd Gregg, New Hampshire Republican.
But observers such as Mr. Reischauer are skeptical, noting that lawmakers still have a lot to work out. Henry J. Aaron, senior fellow in economic studies at the Brookings Institute, said chances are "exceedingly low" because of a poor fiscal situation.
The White House and some lawmakers on both sides, including Mr. Gregg and Mr. Breaux, say any prescription drug benefit must be coupled with an overhaul of the Medicare system; the White House framework includes both. Others balk at that and say Congress should move ahead with a prescription drug benefit under current Medicare.
Rep. Jim Nussle, Iowa Republican and chairman of the House Budget Committee, said adding more money to Medicare without changing the program "is sticking your head in the sand; it won't work."
Cost is also a big factor. Mr. Nussle faced opposition from some within his party for proposing a budget that essentially cut $215 billion from overall Medicare spending over the next 10 years. But he changed course, and the final budget, which the House passed Friday morning, would restore those cuts.
When it comes to policy, the president and other Republicans want to give people choices of private health plans outside of government-run Medicare.
Those who stay in traditional Medicare would get a drug discount card to lower drug costs and would be helped with catastrophic drug costs.
Seniors could also choose a third option, which would use managed-care plans.
In the Senate, Mr. Gregg predicted the big floor debate would happen in midsummer.

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