WASHINGTON, Nov. 21 (UPI) -- The Medicare prescription drug bill headed for House debate Friday as Democrats bitterly complained Republicans were rushing the $395-billion package through without giving them time to read it.
Conferees wound up their work at 1:30 a.m. ET on Friday. Traditionally members get at least three days to consider bills, but in the rush to approve the Medicare deal and close this year's session before Thanksgiving, and in the face of a potential backlash against the bill, House Republican leaders wanted a Friday vote. It generally was expected to pass along party lines.
The bill first went to the House rules committee Friday and, as GOP leadership attempted to ensure Democratic cross-over votes, keeping the support of their own skittish conservatives also remained a priority.
"We'll see how it goes on the floor, but I assure you efforts are underway by us and industry supporters to ensure that the votes are there," said one GOP aide.
"A thousand pages in four hours is not acceptable," Rep. Sheila Jackson Lee, D-Texas, told the Rules Committee but was unsuccessful in getting enough support to keep the committee from denying a motion to delay consideration, sending the bill to the floor.
The Senate, expected to engage in bitter partisan debate, also was to consider the bill Friday, but was not expected to vote until Monday.
Senate Minority Leader Tom Daschle, D-S.D., said he had not yet decided if he would seek to filibuster the bill -- which would require 60 votes -- but Democratic aides told UPI on Thursday they did not think they could muster the support needed to stop the bill.
Democrats were concerned about angering seniors by voting against the bill and going home for the holiday break empty-handed with almost $400 billion remaining on the table.
Democrats expected to support the bill included Barbara Boxer and Dianne Feinstein of California, Ben Nelson of Nebraska, Blanche Lincoln of Arkansas and Mary Landrieu of Louisiana. Democrats John Breaux of Louisiana and Max Baucus of Montana should expect some serious inter-party fighting next year as a consequence of their support, a leadership aide told UPI.
Former Democratic presidential candidate, Sen. Bob Graham of Florida, told reporters his party's goal was to defeat the bill and it was premature to talk about a Senate filibuster.
"It is going to be a very close vote, as the vote we just took on the energy bill was very close," Graham said. "There is a lot of education to be done."
The Congressional Budget Office said late Thursday the compromise bill would cost $395 billion, $5 billion shy of the $400 billion President Bush set aside for a Medicare drug benefit over 10 years.
The bill first would set up a discount card seniors could purchase next April that would give them discounts of between 15 percent and 25 percent on their drug costs.
The actual drug benefit begins in 2006, with an average monthly premium of $35 for that year, a $250 deductible and a government subsidy of 75 percent for all drug spending up to $2,250. In the late days of the conference, committee members reduced the deductible by $25 and increased the spending limit by $50.
Between $2,250 and $3,600 in out-of-pocket beneficiary spending, the bill provides no drug coverage, even though seniors still would have to pay the monthly premium. After $3,600 -- $5,100 in total costs -- catastrophic coverage begins and the government pays 95 percent.
Low-income beneficiaries, who earn up to 150 percent above the poverty line, would receive help paying premiums and deductibles and would not be subjected to the coverage gap.
Democrats criticized the drug benefit platform and said although the lowest-income seniors will be helped, millions of other low- and moderate-income seniors would pay more and receive less than they have now, either via Medigap plans or through retiree coverage.
Democrats objected to a provision that would prohibit Medicare from negotiating volume discounts with pharmaceutical companies -- as do the Veterans Administration and Medicaid, to some extent. They complain this is a windfall for drugmakers.
Democrats also objected to privatization demonstration projects that would, in select areas around the country, test the idea of linking traditional Medicare payments to the amounts private plans participating in the program are paid. If the private plans charged Medicare less than under the traditional program, beneficiaries in the traditional program would be forced to pay higher premiums.
Critics contend privatization will lure healthier and wealthier seniors into private plans, leaving the sickest and poorest in traditional Medicare. If payments are linked to private plans, they said, traditional Medicare could become too expensive for them as well.
Democrats also were unhappy with a $14-billion subsidy for private health plans -- included to entice them to participate in the Medicare program -- and said despite financial incentives for business to keep retiree health coverage, many still would drop that benefit if the Medicare drug is passed.
Responding to criticism from Democrats, the GOP has responded by acknowledging the imperfections in the measure, but also stressing it is the best Congress can muster and better than nothing.
Some die-hard supporters even have argued the privatization provisions and other reforms in the bill represent a key to saving the financially troubled Medicare program -- arguments that have not been supported by statistical analysis.
"This is our chance at passing a prescription drug plan that acknowledges medical reality," said Rep. Tom Delay, R-Texas. "For this to be successful we need to forget about ideological absolutes."
Health and Human Services Secretary Tommy Thompson said although the bill is not perfect, "seniors can't wait for perfect."
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Christian Bourge is UPI's Congressional and Policy Correspondent. Ellen Beck covers healthcare policy for UPI Science News. E-mail [email protected]
