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Medicare bill too close to call in the House

President Bush urges approval

From Ted Barrett
CNN Washington Bureau

President Bush at the White House after a U.K. visit.
President Bush at the White House after a UK visit.

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President Bush is pushing Congress to pass a Medicare overhaul that would add prescription drug coverage.
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America Votes 2004

WASHINGTON (CNN) -- Hours before a scheduled House vote on the Medicare drug bill, Democrats and Republicans Friday were lobbying hard to affect its outcome, and President Bush himself called on lawmakers to approve it.

"It's an important time for members of the U.S. Congress to honor our obligations to our seniors by providing a modern Medicare system, a system that includes prescription drugs for our seniors," Bush told reporters upon emerging from Marine One on the lawn of the White House after a state visit to England.

"I urge the House and the Senate to pass this good piece of legislation," he said.

En route, aboard Air Force One, Bush made four telephone calls to House members regarding pending legislation.

During the day, White House Chief of Staff Andrew Card was on Capitol Hill meeting with wavering Republicans to persuade them to vote for the bill, while senior adviser Karl Rove joined Bush aboard Air Force One in making calls to members of Congress.

Late in the afternoon, observers predicted a vote would be held after midnight.

The boost given the Republicans' effort by the AARP's endorsement of the plan has come under attack from a number of the group's own members, some of whom have accused the group of being influenced by the millions of dollars it gets in royalties for insurance marketed under the AARP name.

In an interview with CNN, AARP CEO William Novelli acknowledged that his group markets insurance products to its members, but said, "We have a wall set up between that marketing and the policy work that we do."

In addition, he said, "By our calculations, we think that we're going to actually lose revenues if this legislation passes."

He deemed such a loss "inconsequential to us. What we care about is getting Medicare out there for the seniors now, and the boomers who are going to retire just a few short years from now."

Novelli predicted passage of the plan "is going to help low-income people, it's going to help people with high drug costs, and it's really going to do a lot, I think, to help drive down" the cost of drugs.

On its Web site, AARP says a survey of its members conducted Wednesday found 75 percent supported the legislation, although only 2 percent said they were "very familiar" with the plan.

House Democratic Leader Nancy Pelosi of California predicted GOP efforts to push the bill through would fail. "They don't have the votes," she told reporters.

Still, Rep. Richard Gephardt, D-Missouri, canceled a scheduled campaign trip to Nevada to vote against the proposal.

"I strongly oppose this legislation because it cheats America's seniors out of a real prescription drug benefit and undermines the basic foundation of Medicare by putting it on a dangerous path toward privatization," the presidential candidate said in a written statement.

GOP leaders said they were trying to persuade about two dozen hard-core conservatives from their party to put aside their opposition to the creation of an expensive new government entitlement.

The conservative bloc could be big enough to sink the measure, unless an almost equal number of Democrats cross party lines to support the prescription drug bill, which was written largely without the involvement of House Democrats.

Undecided Democrats

Estimates of the number of undecided Democrats varied wildly -- from as few as three, said one confident Democratic aide, to as many as 50, said another.

While Democrats have long supported the creation of a prescription drug benefit, most oppose the price that comes with it in the GOP bill -- allowing the possibility of private health plans competing with government-run Medicare.

House Democratic Leader Nancy Pelosi: Republicans 'don't have the votes.'
House Democratic Leader Nancy Pelosi: Republicans 'don't have the votes.'

Despite those misgivings, some undecided Democrats are afraid to leave the budgeted $400 billion for the new benefit on the table. Others want to bring back to their districts part of the $25 billion the bill provides for rural doctors, hospitals and other providers. Many fear a backlash from older voters if they don't approve the AARP-backed bill.

Some undecided Democrats privately grumbled about additional pressure from their leaders, who declared the vote a test of party loyalty.

Though a final House vote is scheduled to be held Friday evening, it could slide to the weekend, aides said.

Senate Democrats were still weighing whether to attempt a filibuster of the bill. But prospects for passage were boosted when two moderate Democrats, Sens. Blanche Lincoln of Arkansas and Ben Nelson of Nebraska, signaled Thursday they would support the measure.

Senate Minority Leader Tom Daschle, D-South Dakota, suggested the bill would pass and that the Senate would then need to come back and improve the benefit.

"My strong belief is that we are going to be forced to revisit this bill," he said.

Conservative House Republicans opposed to the bill got a boost Thursday when The Wall Street Journal published an editorial with the headline, "Entitlements are Forever."

Rep. Mike Pence, R-Indiana, took to the House floor to warn colleagues the paper "makes a powerful case that Congress should reconsider before we create this massive new government entitlement."

But GOP leaders argued the bill's tax-free health savings accounts and cost-containment measures should calm fiscally nervous Republicans.

Rep. Bill Thomas, R-California, who helped write the bill, said it creates "significant and sweeping improvements to Medicare."

"The legislation is not perfect, but it is very, very good," added Senate Majority Leader Bill Frist, R-Tennessee, who is a medical doctor.

Last-minute snags prevented negotiators from signing off on the deal Thursday afternoon.

Small changes were made to the bill earlier in the day. The annual deductible was lowered to $250 from $275, after budget experts determined the total cost of the bill would be $5 billion less than the allotted $400 billion.

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