WASHINGTON, Nov. 26 (UPI) -- President George W. Bush's proposal to revamp Medicare and provide prescription drug coverage for seniors will likely return to center stage as a critical pre-2004 election issue with Republicans set to take control of the U.S. Congress in January.
Congress struggled in July to agree on a prescription drug plan that would help the nation's 34 million Medicare beneficiaries pay the escalating costs of medications. But a partisan impasse prevented a bill from reaching Bush's desk for his signature despite attempts by GOP and Democratic moderates to hammer out a deal both sides could live with.
Jim Manley, spokesman for Sen. Edward Kennedy, D-Mass., told United Press International that two factors would drive the destiny of a prescription drugs plan during the next session: cost and how the benefits are delivered to the American people.
"Those are going to be the two flashpoints of controversy," said Manley.
Kennedy, along with Sens. Bob Graham, D-Fla., and Zell Miller, D-Ga., favored a government-administered plan requiring a $25 monthly premium payment, a $10 co-payment for generic drugs and $40 for brand-name drugs, with a $4,000 cap for out-of-pocket expenses. The estimated cost was some $594 billion over 10 years.
Conversely, Republicans backed a bill with an estimated $340 billion price tag that would have provide government-administered program with drug subsidies for low-income beneficiaries. The House had passed a drug bill that would have cost $320 billion over 10 years and would have been administered by private drug companies.
"Democrats thought that was inadequate this year, and obviously given the cost of inflation and the rising cost of prescription drugs, that will even less possible to deal with next year," Manley said, of the GOP proposal.
An escalating federal budget deficit will also complicate the debate over the cost of a prescription drug plan, Manley said. The Congressional Budget Office estimates the federal government will face a $157 billion deficit this year, the result of a slump in tax revenues coupled with double-digit spending growth.
Democrats will also likely balk at any attempt to privatize the delivery system for any proposed drug plan, Manley said. Manley said a tri-partisan group of senators has been trying to forge a compromise bill on which Democrats and Republican could agree in the upcoming session that addresses privatization.
During the 107th congressional session, the issue fueled an already bitter partisan division among Senate lawmakers. Senate Majority Leader Tom Daschle, D-S.D., told reporters last week Republicans made the strategic decision not to give Democrats credit for any legislative progress, including that on prescription drugs.
"I think they made the decision: Let's not allow them the opportunity to say anything was accomplished. I think in every one of the competitive Senate races, I heard the accusation: Well, the House passed the prescription drug bill, but the Senate didn't. That was their mantra," Daschle said.
"Now, the election is behind us. They won't have the reason that I think motivated them to take the position they did from July to November, this coming January. So I think the environment is going to be different, the legislative environment will be different. And I think that there is a way to find common ground on many of these issues," Daschle said.
Democratic strategists predicted Republicans would place Democrats in the uncomfortable position of possibly filibustering any GOP-backed bill they believe is undesirable. That likely will not do much for the Democratic Party's image generated during the 107th session that its leadership was purposefully blocking progress on critical legislation.
The GOP has accused the Democratic leadership of being obstructionist, while the Democrats have countered with charges that Republicans were too closely aligned with the pharmaceutical companies and sought to provide only minimal benefits to a limited number of seniors.
Republicans on Tuesday called those assertions ridiculous, saying their only goal is to enhance seniors' access to medications while preserving the pharmaceutical industry's ability to engage in progressive research and development.
The Bush White House has estimated 77 million Americans would be in Medicare by 2030. Under the president's proposal, the Medicare Rx Drug Card Program would provide pharmacy discounts to seniors. The initiative would secure manufacturer rebates and pass them on through to pharmacies and beneficiaries, resulting in lower prices.
"We will not rest until we've reformed and strengthened the Medicare program itself so that a prescription drug benefit is available to every senior in America," Bush promised Americans last month during a Rose Garden event.
Then the president praised the House for passage of a White House-backed plan, but lambasted the Democratically-controlled Senate for "failing to act" and approving a similar plan.
A second initiative Bush proposed, the Pharmacy Plus Program, would allow states to use their Medicaid programs that serve the indigent, to provide drug-only coverage for low-income seniors. And the Medicare Low-Income Drug Assistance program would make it possible to phase in comprehensive drug coverage to beneficiaries with incomes up to 150 percent of the federal poverty level, or $17,000 for a family of two. The federal government would pay 90 percent of the costs of the plan and states would be responsible for the remaining 10 percent.
