- The Washington Times - Monday, November 24, 2003

Conservative policy advocates yesterday condemned the Medicare reform bill, calling it a big-government monstrosity whose entitlement costs will explode when baby boomers begin retiring after 2010.

But most of these analysts also said the prescription-drug bill would not undermine relations between them and President Bush, who pushed for its enactment. In fact, many said that despite their opposition to the bill, it would be a political winner for Mr. Bush and the Republican Party if it becomes law.

The House approved the measure on a largely party-line vote, 220-215, early Saturday morning. It now goes to the Senate, where it faces a likely Democratic filibuster attempt.

Officials from almost all of the major conservative think tanks in Washington and some two dozen other fiscally conservative advocacy groups used words like “terrible,” “horrible” and “depressing” to describe the White House-backed bill they fought to change.

“It’s a triumph of Republican politics and Democratic health care policy,” said Robert E. Moffit, director of health policy at the Heritage Foundation. “Republicans have laid the groundwork for a universal entitlement in Medicare of unknown costs that will continue to grow relentlessly under the inevitable pressure to fill in the remaining gaps in coverage,” he said.

Mr. Moffit and like-minded policy strategists see the bill as a setback for conservative reform and a major retreat by Mr. Bush, who embraced a far more privatized, market-driven approach in his 2000 campaign.

That approach, spelled out in a bipartisan health care commission in 1999, was modeled on the Federal Employee Health Benefits Plan that allows government workers to choose from a range of competing, private health care plans that have effectively restrained cost increases.

The biggest setback for these conservatives is the bill’s rejection of a proposal to force Medicare to compete with private health care plans nationwide. Instead, in an effort to placate Democrats who want no private competition, the bill calls for a six-year, six-city demonstration program starting in 2010.

“That’s only 1.6 percent of all the metropolitan areas in the U.S. Give me a break,” Mr. Moffit said.

Similar complaints were voiced by other conservatives at the American Enterprise Institute, the Cato Institute and elsewhere.

“To some degree, Republicans really got rolled on this,” said Michael Tanner, chief domestic-policy analyst at Cato, a libertarian think tank. “They backed themselves into a corner by promising in the last election a prescription-drug bill.”

Said John Goodman, president of the National Center for Policy Analysis: “This is really a horrible day.”

A few conservatives are backing the bill. Former House Speaker Newt Gingrich said he believes the bill’s medical savings accounts will reap bigger savings and lead to future reforms.

Grace-Marie Turner of the Galen Institute also supports the bill.

“The negatives are serious,” she said, but added that on balance it contains enough incentives for more preferred providers and health maintenance organizations to participate in Medicare.

Some conservative leaders, however, said the reformers had only themselves to blame because they did not come up with an easily understandable reform model.

“We never had a significant policy debate. A few staffers at Heritage is not really a dialogue. We didn’t make the case. We didn’t have a model,” said a top conservative leader who asked not to be named.

Grover Norquist, president of Americans for Tax Reform, said his group was taking no position on the bill. Still, he agreed with Mr. Gingrich that the bill’s tax-free medical savings accounts “are the most important part of the bill, though the people who say this will enlarge entitlements have a case to be made.”

Few, if any, of the conservative policy analysts said the bill would result in a rift between themselves and the White House. Even so, they wondered how much they can trust the administration to hold its ground in future reform debates.

“I don’t think this is a good sign for the future of real reform of Social Security. There’s a disturbing pattern here. It is not enough to send broad principles of reform to Capitol Hill and let Congress work its will, without direct presidential involvement,” Mr. Moffit said.

But no one has any doubt that if the bill becomes law, it will be a major political victory for Mr. Bush, boosting his re-election chances. A poll last week by the 35-million-member AARP, which endorsed the bill, found that 75 percent of its members support it.

“Politically, this is a very popular bill. The costs don’t come until well down the road. It delivers short-term benefits to the needy. It fulfills a Bush campaign promise and takes a Democratic issue off the table,” Mr. Tanner said.

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