- The Washington Times - Thursday, November 20, 2003

House and Senate negotiators finalized the landmark Medicare prescription-drug bill yesterday, setting up a struggle in both chambers over the next few days that Republican leaders say they will win.

The House is expected to consider the legislation today, with the Senate to follow suit. The measure is the biggest expansion of federal entitlements since 1965.

“I predict we will pass this legislation in a bipartisan way in both bodies sometime in the next few days,” said Senate Majority Leader Bill Frist, Tennessee Republican and Medicare bill negotiator.

The Congressional Budget Office estimates the measure will cost $395 billion over 10 years. Negotiators met formally to approve the bill yesterday afternoon and were expected to officially sign off on it last night.

Republican leaders were still counting votes yesterday, however, and trying to persuade unhappy party members to back the measure.

“I welcome Democratic support, but at the end of the day I’m confident we’ll have the votes on our side to pass this,” said Rep. Eric Cantor, Virginia Republican and chief deputy majority whip.

“They still don’t have the votes,” said one House Republican aide, who predicted as many as 40 Republicans could vote no, largely because conservatives think the bill inadequately reforms Medicare.

Rep. Mike Pence, Indiana Republican and key opponent, said yesterday morning that he expects roughly 25 House Republicans to vote no.

Supporters of the bill, including Democrats, say now is the time to pass such legislation, which will update Medicare and create a prescription-drug benefit for seniors.

During negotiators’ official meeting yesterday, Majority Leader Tom DeLay, Texas Republican, sent a message to conservatives noting the bill contains the first real reforms to Medicare since its creation and “this is probably the last opportunity” to enact those reforms before Medicare goes bankrupt.

Sen. Max Baucus of Montana, who helped craft the deal, told his fellow Democrats that Medicare, “is not undermined” in the bill and that $400 billion “may not be on the table in the future.”

There seemed to be more Democratic support in the Senate than in the House. Sen. John B. Breaux of Louisiana, the second key Democrat who helped craft the bill, predicted a “significant number” of Senate Democrats will vote yes.

Sens. Ben Nelson of Nebraska and Mary L. Landrieu of Louisiana have already declared their support.

Mrs. Landrieu stood yesterday with Mr. Breaux and Mr. Frist at a press conference highlighting the bill’s help with drug costs for low-income seniors — a clear pitch to Senate Democrats.

Democratic leaders in both chambers say the bill provides a paltry drug benefit, tips the scales too far toward private health plans, and is designed to ruin Medicare.

“This is a raw deal for America’s seniors and a windfall for HMOs and big drug companies,” said Sen. Edward M. Kennedy, Massachusetts Democrat.

The House Democratic leadership is working hard to ensure their members vote no, though aides from both parties say some will support the measure in the end.

Conservative Republicans meanwhile are upset that reforms they wanted were watered down.

A requirement that Medicare compete directly against private health plans starting in 2010 was scaled back to a six-year pilot project in six cities. Conservatives also wanted a cap on the overall cost of the new Medicare drug benefit, but the bill only includes a mechanism requiring Congress and the president to examine Medicare costs once they climb too high.

“This bill … falls short of the needed reforms,” said Rep. Patrick J. Toomey, a Pennsylvania Republican who said he will vote no.

Still, Republican leaders have pushed the bill effectively, especially touting the bill’s $6 billion for tax-preferred health savings accounts, which encourage individuals to save for their medical expenses — a Republican priority. Some will vote for it quite reluctantly, however.

“I’m going to hold my nose, close my eyes, bite my tongue and vote for it,” said Rep. Lamar Smith, Texas Republican, who hopes that “we’ll be able to add more private-sector involvement in future years.”

Even some Republican Medicare negotiators were not thrilled with the cost of $395 billion over 10 years.

“I will predict right now it will come out double that,” said Sen. Don Nickles of Oklahoma, who said he may not vote for it on the Senate floor.

Medicare programs have a history of exceeding their projected costs.

When the initial program, hospital insurance, was instituted in 1965, it was expected to cost $9 billion in 1990. The actual cost in 1990 was $67 billion. In 1988, when the Medicare home-care program was established, the 1993 projected cost was $4 billion, while the actual cost was $10 billion.

But conservatives were feeling pressure to support the bill yesterday from an unlikely but important group: the National Right to Life Committee.

The group said in a statement yesterday that it “strongly opposes government-imposed rationing of life-saving treatment and considers it a form of involuntary euthanasia.” Therefore the group said it wants people to have the option of getting medical care through private plans instead of moving toward government-rationed health care.

The NRLC is counting the Medicare bill as a pro-life vote and is e-mailing constituents in districts where pro-life lawmakers are undecided, angering many conservatives.

“When groups like NRLC take a stand on issues that have nothing to do with the life issue, it substantially undermines their credibility,” said John Hart, spokesman for Rep. Jim DeMint, South Carolina Republican.

A key provision in the bill would for the first time help seniors with their drug costs for a monthly premium of about $35 and an annual deductible of $250, which negotiators lowered in the last few days from $275. Low-income seniors will get substantially more help.

Copyright © 2019 The Washington Times, LLC. Click here for reprint permission.

The Washington Times Comment Policy

The Washington Times welcomes your comments on Spot.im, our third-party provider. Please read our Comment Policy before commenting.


Click to Read More and View Comments

Click to Hide