Bush Prods Congress on Medicare Drugs
President Bush prodded lawmakers Wednesday to approve a prescription drug benefit and choice in health care coverage “for the sake of all our seniors” by the Fourth of July.
“This year we have an opportunity to seize and strengthen and improve Medicare,” Bush told the Illinois State Medical Society. “I’m here to urge Congress not to miss the opportunity.”
Senate Democratic Leader Tom Daschle predicted the Senate will approve far-reaching Medicare legislation in the next few weeks.
After Daschle and other Democrats criticized the legislation for failing to go far enough to meet the needs of seniors, the South Dakota Democrat left open the possibility he could wind up voting for it, depending on changes incorporated into the bill.
“I think it will pass,” Daschle said.
The Senate Finance Committee is scheduled to vote Friday on a measure providing prescription drug coverage while offering a new managed care option for seniors. Sponsors have expressed confidence they have the votes to prevail. That would set the stage for full Senate debate during the last two weeks of the month.
The GOP-controlled House is at work on a bill of its own, and ready to move quickly on it. Republican sources described the emerging plan as similar to the Senate bill, although it includes the controversial concept of making higher-income seniors pay more of their own prescription expenses than the less well off.
With momentum gathering on Capitol Hill, Bush made a trip to the Midwest to exert pressure on the process.
White House aides have success in their sights, hoping for a politically popular achievement that Bush and fellow Republicans can take on the campaign trail next year. Answering seniors’ pleas for coverage under Medicare for skyrocketing drug costs has long been a wish item in Washington, but has always met with gridlock.
Protesters opposed to the Republican plans greeted Bush upon his arrival here.
William McNary, president of U.S. Action and codirector of Citizen Action/Illinois, said the president’s prescription drug plan “pushes seniors into HMOs, and its unaffordable.”
Some 200 people gathered outside the hotel, chanting “The Bush plan has got to go!” and “We don’t want your HMO.” Protesters also carried signs reading “Don’t privatize Medicare”
In a private meeting Tuesday, Bush told Republican leaders from both houses the issue was a top priority, Rep. Christopher Cox, R-Calif., said. But the wide-ranging session in the president’s residence – and the president’s remarks in a gilded ballroom here Wednesday – skimmed past the divisions between the White House and Republicans in Congress over the best way to give seniors drug coverage.
The administration wants to offer better benefits to seniors who choose to enroll in Preferred Provider Organizations, part of a desire to modernize the 38-year-old program and shore up its finances through private-sector competition. Under the Senate plan, though, seniors would receive equivalent drug benefits regardless of whether they purchase coverage under traditional Medicare or choose to enroll in a PPO.
The White House has made plain that Bush still prefers incentives for seniors to join PPOs, but that he was declining to quarrel with details of the proposals at this stage.
“What’s important to the president is for the process to continue to move,” Bush spokesman Ari Fleischer said.
By putting off efforts to shape the final product more to his liking until later in the process, Bush would be following a model he has used successfully in the past, in part by appealing directly and repeatedly to the public.
In addition to the Chicago speech, Bush was to deliver a Medicare address in Connecticut on Thursday. He devoted last Saturday’s radio address to the topic.
After a round-table with a half-dozen doctors and seniors, Bush lauded the benefits of offering seniors the ability to tailor their health care coverage to fit their personal needs. He also said that adding drug coverage to Medicare would save money in the long run, for example, by using medicines that prevent the need for expensive long hospital stays.
Bush said as many as one-third of America’s seniors have no drug coverage.
“Medicine is changing, Medicare is not,” Bush said. “Time and time again, Medicare’s failure to pay for drugs leaves our seniors at risk of serious injury, illness and disease, all of which Medicare would pay to treat after the fact.”
The Senate proposal, unveiled by Senate Finance Committee Chairman Charles Grassley, R-Iowa, envisions stand-alone prescription drug coverage, starting in 2006, through private companies under government-dictated terms.
For the first year, seniors would pay a monthly premium of about $35; the first $275 in costs; half the bills between $276 and $3,450; everything between $3,450 and $5,300; and 10 percent of costs over that amount. Insurance would pay the remainder.
Low-income seniors would receive government subsidies. And if private companies were not willing to offer coverage in some parts of the country, the government would step in.
The Senate plan also would require Medicare recipients to pay a higher deductible for doctor services, $125, up from $100, beginning Jan. 1, 2006, with future rises tied to inflation. It would be the first such increase since 1991.
Senate Democrats are divided over the plan, with some worried the new drug benefits won’t do enough to help cash-strapped seniors. Other Democrats are concerned that the changes could lead to privatization of the government program.
Daschle has been sharply critical of the bill in the past, and said it was his intention to “do all that we can to improve the bill.”
The House proposal, meanwhile, would introduce “means-testing” into a program which historically has offered a standard benefit regardless of income.
Under that version’s drug coverage, seniors would pay a $250 deductible, 20 percent of the next $2,000 in bills, then all the costs until out-of-pocket expenses reached $3,700 a year, one source said. Insurance would cover all costs above that, and the remainder below.
The $3,700 cap on out-of-pocket expenses would rise for seniors with incomes over $60,000.
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AP Special Correspondent David Espo contributed to this story.