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Conservatives question cost of drug benefit

Pence: 'We came here to make government smaller'

From Ted Barrett
CNN Washington Bureau

The cost of prescription drugs has become a big concern for many of America's seniors.
The cost of prescription drugs has become a big concern for many of America's seniors.

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The phrase 'politics makes strange bedfellows' was never so true as the bipartisan prescription drug bill agreed upon by President Bush and Sen. Ted Kennedy. CNN's Jonathan Karl reports. (June 25).
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WASHINGTON (CNN) -- Some conservative lawmakers, worried over the cost of a new government entitlement, say they might not vote for a $400 billion Medicare prescription drug benefit.

President Bush, who wants to create the benefit, called more than a dozen wavering lawmakers to the White House Wednesday to press the point.

"Whatever amount of energy and effort is required from the White House, we will provide it to get a bill done this summer," Bush said. "We can all go back to our districts -- in my case the country -- and say that we have accomplished a major objective together."

The House was expected to vote on the measure Thursday, but the final vote could slide to Friday if GOP leaders need more time to shore up votes, aides said.

"This is one of the toughest, most complex pieces of legislation that we've tried to put together in our lifetime," said House Speaker Dennis Hastert, R-Illinois, said after a lengthy session listening to the concerns of House Republicans.

While estimates vary, various lawmakers and aides said more than two dozen conservatives may vote against the expansion of Medicare. That could be enough to derail the bill in the House, which has 223 Republicans and 209 Democrats, unless enough Democrats bolt from their leadership to make up the difference.

Rep. Mike Pence, R-Indiana, who was summoned to the White House Wednesday, said afterward that he remains unconvinced.

"I think many conservatives are fundamentally opposed to creating universal drug benefits for seniors that would be the first major new entitlement Congress has created in a generation," Pence said.

"We simply didn't come here to increase entitlements and to create bigger government. We came here to make government smaller."

Pence and other conservatives maintain that the costly prescription drug benefit should only be added if fundamental reforms are made in Medicare, which provides health care for the elderly and disabled.

While many House Republican leaders share Pence's concerns, they are nonetheless trying to convince their conservative colleagues to support the House bill, pointing out that politically potent seniors are clamoring for the coverage.

GOP leaders also argue that the House bill -- with its emphasis on using free market competition to bring down costs -- is preferable to the Senate version supported by their ideological nemesis, liberal stalwart Sen. Ted Kennedy, D-Massachusetts.

"It's the right thing to do," Hastert said. "We've said for two Congresses we want to deliver a prescription drug package. We're at the point now that we have to make sure policy and politics are married up, that we can deliver to the American people what we said is the right thing to do."

House leaders are offering incentives to wavering conservatives to win their votes, including a $6 billion provision to increase Medicare payments to rural providers and a measure designed to speed lower-cost generic drugs to market.

Leaders are also considering including a proposal to allow the importation of U.S.-made drugs from countries such as Canada and Germany.

The Senate has debated amendments to its prescription drug bill this week, and final passage could come late Thursday.

Differences between the House and Senate bills would need to be resolved next month by a conference committee before the measure could be sent to Bush for his approval.

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