- The Washington Times - Monday, March 3, 2003

A humbled White House has scaled back its plan to lean heavily on managed-care plans to provide prescription drugs to seniors, leaving Congress to take the lead on Medicare reform.
Health and Human Services Secretary Tommy G. Thompson was grilled by both Republicans and Democrats on Capitol Hill last week because of the vagueness of the White House reform plan. Some details known last week were pilloried by the chairmen of the House Budget and Senate Finance committees.
Rep. Jim Nussle, Iowa Republican and chairman of the House Budget Committee, said he is tired of returning to his district every year and telling senior citizens that Medicare reform has been delayed yet again.
Sen. Charles E. Grassley, Iowa Republican and chairman of the Senate Finance Committee, expressed his displeasure to Mr. Thompson about aspects of the foggy White House plan which came with a $400 billion, 10-year price tag but few other details and made it clear that Congress will be taking the lead on Medicare reform.
"I'm not going to let [the $400 billion] sit there all year while we wait for the White House to sign off on the details," Mr. Grassley said. "Plan or no plan, I'm moving ahead."
An aide for James P. Moran, Virginia Democrat, said Mr. Nussle's animated statements to Mr. Thompson almost outshone the frequently sharp-tongued Mr. Moran.
"When you see that, it shows that the Bush administration is not thinking through a lot of its policies," the aide said. "You are finding that Republicans who are normally in lock-step with the administration are instead walking away."
An attempt to walk across the bridge is likely to start with Mr. Grassley. He will use the so-called "tripartisan" Medicare reform plan that stalled in the Senate last year as a starting point for reform, said spokesman Jill Gerber.
"He hasn't said that is the way he expects the Senate to go this time," Miss Gerber said. "But he likes the approach and he feels it's been scored by the Congressional Budget Office and would get more bang for the buck."
The tripartisan plan so named because it had the support of Republicans, Democrats and independent Sen. James M. Jeffords of Vermont would have covered 100 percent of the prescription-drug costs of low-income people, and allowed others to pay a reduced cost, with the federal government picking up a large part of the tab after the enrollee spent $3,700.
The White House is expected to introduce a scaled-back version of its Medicare prescription-drug plan this week. And aide to Mr. Nussle suggested that it had better include "real changes" in the structure of Medicare to improve its fiscal solvency if it is to be taken seriously in the budget process this year.
A plan the White House touted last fall relied on issuing discount cards for prescription drugs for those who remained in the Medicare program, offered catastrophic coverage for high drug expenses and gave additional subsidies for those with low incomes.

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