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Democrats line up against GOP prescription bill as House prepares to vote
WASHINGTON (CNN) -- As the House of Representatives gears up for a vote on a Republican-drafted bill to provide prescription drug coverage for Medicare recipients, minority Democrats and advocacy groups are working behind the scenes to sink the bill, which many describe as nothing more than "political cover" for an election year.
The bill, which was approved by the House Ways and Means Committee last week, is the Republicans' response to nearly two-years-worth of sharp partisan combat over the issue of drug coverage for seniors who rely on the massive federal insurance program to cover their basic health care costs.
At present, Medicare does not help senior citizens in any way with prescription drug costs.
With the per-prescription cost of pharmaceuticals rising steadily, and with many seniors on fixed incomes forced to make decisions about the number of prescriptions they can afford versus other of life's basic necessities, both parties have been pressed by advocacy groups since last Spring to come up with a legislative solution.
While congressional Democrats and the Clinton administration favor the outright addition of a uniform prescription drug provision to Medicare -- allowing some 39 million beneficiaries the option of obtaining their drugs for a minimal copay -- the House Republican plan would place the onus of drug coverage on private insurance providers, allowing them to set the parameters of coverage.
According to the text of the GOP bill, which should debut on the House floor on Wednesday, private insurance companies would be presented with a series of federal subsidies aimed at enticing them to provide some form of drug coverage to Medicare recipients of moderate income, with special provisions included to help low income seniors and those with experiencing extraordinarily high costs.
The House GOP estimates that under its plan, the average beneficiary would pay $35 to $40 per month in prescription insurance premiums, then half the cost of their yearly prescriptions up to $2100. Insurance coverage would then cease until yearly layouts by an individual hit $6,000, at which point a "catastrophic cap" would kick in pay for all drugs.
A rival plan birthed by Democrats nearly a month ago would extend their universal drug benefit to Medicare beneficiaries, whether they are enrolled in the traditional Medicare fee-for-service program, a Medicare Health Maintenance Organization, or a retiree health plan. That benefit would cover up to $5,000 in drug costs annually per eligible individual, in most cases.
The Republican bill has endured criticism from almost every quarter outside of the congressional majority and their supporters within the insurance and health care industries, while Republicans have characterized the Democratic plan as too ambitious, and too expensive.
Democrats say the Republican bill provides no guaranteed coverage by leaving all such decisions to private insurers. With insurance companies setting their own policies, they argue, the drug coverage proposal runs the risk of creating a massive, new federal bureaucracy charged with keeping track of what companies offer which benefits.
"In their desire to do anything but create a real prescription drug benefit under Medicare, the Republicans' proposal creates a 'Rube Goldberg' structure that involves subsidizing insurance to do what they do not want to do, while creating a new government bureaucracy in Medicare," said Rep. Ken Bentsen, D-Texas.
Medicare premiums paid by seniors would rise sharply under the GOP plan, Bentsen argued, if insurers are given freedom to set policies and coverage levels. But, he added, there is every chance in the world that not too many health insurers would be willing to sign on to a proposition that could be very difficult to maintain.
"There is one thing the Republican sponsors missed or are not telling us," Bentsen continued. "Health insurance companies do not like it, and will not do it."
At a Capitol Hill rally on Tuesday, leaders of a number of advocacy organizations ripped into the Republican bill, many echoing Bentsen's criticism.
"My opposition to this bill is based on the belief that its performance will not live up to its promise," said Samuel Simmons, head of the National Caucus on Black Aged.
"There is no defined benefit, and the entire bill is based on the premise that the insurance companies will offer coverage to everyone," Simmons said.
In spite of the criticism, members of the House GOP leadership expressed confidence Tuesday that the bill would pass the next day, and that senior citizens would welcome it.
"Tomorrow we will pass a pharmaceutical plan that takes care of the neediest in our society," said House Speaker Dennis Hastert, R-Illinois. "Older Americans deserve financial security and health security."
Last week, the Senate rejected by a vote of 53-44 its own version of the Democratic prescription drug proposal. Senate Democrats had to employ the Senate's complicated floor rules to get that bill to the floor, over the objections of the GOP leadership.
A similar Democratic bill may be considered in the House when the Republican proposal comes to the floor, though chamber members have yet to hammer out their parameters for the day's debate.
A carrot on a stick
Rather than the sort of procedural maneuvering exercised by the Senate Democrats, President Clinton made an attempt to entice House Republicans to pass the Democrat-favored plan with a promise to support their efforts to bring an end to the so-called marriage penalty -- the extra $1200 to $1500 paid in taxes every year by married couples.
The president offered his deal on Monday, when he announced a newly projected $1.9 trillion federal budget surplus over 10 years.
Republicans appeared unwilling to take the deal, and planned to push ahead with their own bill.
White House spokesman Joe Lockhart said Tuesday that the president's offer to merge his Medicare prescription drug package with the Republican's marriage tax penalty cut was a "good faith offer" meant to break the current legislative "logjam."
Lockhart chided House Ways and Means Committee Chairman Bill Archer's rejection of Mr. Clinton's proposal. In a statement Monday, Archer said Republicans would not accept a tax cut that offered "pennies" to American families in exchange for more government spending.
"In trying to respond to the president's program, he criticized his own program," Lockhart said of Archer. "I don't really think he believes that. I don't really think that the marriage penalty just provides pennies to people and I think as the days go on and as the support for a prescription drug benefit builds, I think many Republicans will see the wisdom of this approach."
Reuters contributed to this report.
Tuesday, June 27, 2000
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