Sunday, November 23, 2003

The House passed a sweeping Medicare prescription-drug bill early yesterday, but only because Republicans would not let the measure die and refused to end the vote until enough lawmakers switched from “No” to “Yes.”

After substantial arm-twisting by Republican leaders, the Medicare bill passed at 5:53 a.m. by a vote of 220-215. It now goes to the Senate, where a key vote is expected tomorrow and where backers had hoped to avoid a Democratic filibuster.

“I feel much better this morning, now that the House of Representatives passed this legislation,” said Sen. John B. Breaux, Louisiana Democrat, who worked with Republicans to craft the bill. “I think you’ll see an entirely different atmosphere in the Senate.”

Mr. Breaux and Senate Majority Leader Bill Frist, Tennessee Republican, said support in the Senate would be broader than in the House.

“I believe it’ll be a strong bipartisan vote. This is a bipartisan bill,” Mr. Frist said.

But yesterday afternoon, Sen. Edward M. Kennedy, Massachusetts Democrat, said the way Republicans “rigged” the House vote prompted him to lead a filibuster.

“I think this bill would have been beaten on a fair vote in the House of Representatives, and so it was a phony vote in the House of Representatives, and now they are trying to jam us in the Senate,” Mr. Kennedy said.

“At this time, I think it’s still an uphill battle, but I think last night should be sufficiently outrageous to any Democrat, and to the American people, that they say we ought to just give time to do better,” he said.

However, President Bush, who has made the bill a major part of his domestic agenda, called on the Senate to follow the House’s lead.

“It is time for the Senate to act. I urge the Senate to pass this good piece of legislation so that I can sign it into law,” Mr. Bush said in a statement yesterday.

Bush had called wavering lawmakers from Air Force One on his way home from London to lobby for passage, Reuters reported. His top political aide, Karl Rove, placed calls from Buckingham Palace, several House Republicans said.

At stake is the largest new entitlement program since Medicare initially passed nearly 40 years ago. The bill is expected to cost $395 billion over 10 years.

The measure would give millions of seniors voluntary prescription-drug coverage for the first time for a premium of about $35 a month and an annual deductible of $250. The government would pay 75 percent of a senior’s annual drug costs up to $2,250.

Beneficiaries would pay out-of-pocket costs between $2,250 and $3,600, the so-called “doughnut hole,” and, beyond that point, the government would pick up 90 percent of costs.

For those seniors who choose to stay with traditional Medicare, private insurers would provide the drug benefit. Or users could choose a new option that would let private insurers provide comprehensive health insurance, including prescription drugs.

Republicans also tried to instill long-term reforms through a pilot program in which Medicare would compete directly against the private plans, starting in 2010 in a six-year, six-city test.

The House began debating the bill Friday and began voting at 3 a.m. yesterday. The voting usually last between 15 minutes and half an hour while members come to the chamber and record their votes.

But an hour into the Medicare vote, Republicans were losing, 216-218, and simply refused to gavel the vote closed until they swung enough votes to win. Top Republicans and Health and Human Services Secretary Tommy G. Thompson prowled the floor for two hours, until they convinced some Republicans to change their votes.

“People came into this thing unpersuaded, and it takes time to do that. A vote is a pressure cooker sometimes,” said House Speaker J. Dennis Hastert, Illinois Republican.

Democrats were furious.

“They grossly abused the rules of the House by holding the vote open. The House expressed its will, 216-218,” said Rep. Jerrold Nadler, New York Democrat. “It means it’s a dictatorship. It means you hold the vote open until you have the votes.”

Just before 6 a.m., two Republicans agreed to switch from “No” to “Yes,” giving the bill 218 supporters, a majority. Once that was clear, Rep. David Wu, Oregon Democrat and the sole member who hadn’t voted, then voted “Yes,” and a few Republicans and Democrats switched votes to bring the tally to 220-215.

Sixteen Democrats joined most Republicans in supporting the bill, though 25 Republicans voted “No.”

Rep. C.L. “Butch” Otter of Idaho and Rep. Trent Franks of Arizona were the two Republicans convinced to switch.

Mr. Otter said he became convinced the alternative to the bill was even worse. He said he believed that if the bill failed, Democrats would push to pass a more expensive version that lacked the provisions conservatives were happy about in the compromise measure.

“I was afraid [of] what was going to happen if I didn’t [switch],” Mr. Otter said. “We’d end up with the more expensive, less reform, no [health savings accounts] Senate bill.”

The political fallout is not clear, but there is no doubt the prescription-drug issue will play a significant role in the 2004 elections and beyond.

“This is not the end of this battle, no matter what happens on Monday or Tuesday or Wednesday,” Mr. Kennedy said. “Anybody that thinks it’s all over next week is absolutely mistaken. This is going to be raised, and a key issue, for Congress and every Senate race, as well as the presidential race in 2004, and it will in 2006, it will in 2008, and it will in 2010, until it’s changed.”

Already yesterday, Sen. John Kerry of Massachusetts, one of nine Democratic presidential candidates, said he will cancel his campaign events and return to Washington to help with the filibuster.

Sen. John Edwards of North Carolina, another presidential candidate, said he will come back to Washington to vote against the bill.

Meanwhile, the National Republican Congressional Committee released a statement criticizing House Minority Leader Nancy Pelosi, California Democrat, for organizing Democratic opposition. Carl Forti, NRCC communications director, promised “not to let seniors forget about this morning’s vote.”

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