Senate haggles over Rx proposals

By Janelle Carter

Senators scrambled to find a compromise between two Medicare prescription drug proposals after neither plan captured enough votes to win Senate approval.

In the first of a pair of votes Tuesday, the Senate rejected, in a 52-47 vote, a plan pushed by Democrats that would spend $594 billion over several years on a drug benefit. A plan that would spend $370 billion and was mostly promoted by Republicans and a few Democrats failed in a 48-51 vote. Both were short of the 60 votes needed for passage under Senate budget rules.

With both parties trying to gain political advantage on an issue that may be important in the fall elections, senators indicated a willingness to get something passed.

“We are to take what happened not as a signal for defeat but rather as a call to action,” said Sen. Bob Graham, D-Fla., an author of the Democratic plan. “We’ve got to work hard to find that middle ground.”

Sen. Charles Grassley, R-Iowa, said after the vote, “I would meet with anybody, anyplace.”

Lawmakers immediately began to huddle over the plans. A Democratic meeting Tuesday afternoon included Graham, Finance Committee Chairman Sen. Max Baucus, D-Mont., health committee chairman Sen. Edward Kennedy, D-Mass., and Sen. John Breaux, D-La., an architect of the plan touted by the Republicans.

“Unless we are able to reach a legitimate compromise we will once again give to the nation’s seniors what we have given them in the past — excuses,” Breaux said.

Senate Majority Leader Tom Daschle, D-S.D., insisted, “Everything is on the table.”

Still, as lawmakers struggle to find common ground, they face huge challenges, including dwindling time as the Senate prepares to adjourn next week for summer recess and major philosophical differences that date back to Medicare’s inception 37 years ago.

Democrats mostly want a Medicare program run by the government. Republicans favor paying private insurers to offer the benefit as a way to promote competition and drive down costs.

The Democratic plan offers low deductibles and a flat co-payment for drugs as part of its government-run program. The less expensive GOP-backed proposal would require the government to pay half the cost of a prescription drug rather than creating a flat payment. It also includes money to create an optional alternative to traditional fee-for-service Medicare.

Both bills offer subsidies for the low-income elderly.

Republicans complained that in addition to busting the budget, the Democratic plan is not permanent and expires in 2010. Democrats countered that they had a plan seniors could depend on, with fewer risks and out-of-pocket costs.

“This is the same debate we had in 1965,” Daschle said. “I don’t think they (the private sector) are any more prepared to deliver today than they were in the 1960s.”

Tuesday’s debate became testy as lawmakers compared it to the Medicare battle. After Senate GOP Whip Don Nickles, R-Okla., criticized the Democratic measure, Sen. Tom Harkin, D-Iowa, said it was too bad Nickles wasn’t in the Senate in 1965. “He could have joined the chorus of voices — voices on that side of the aisle — that argued against Medicare. He’d have fit right in,” Harkin said.

Nickles, standing a few feet away on the Senate floor, shot back, “I wonder why you’re guessing what I might have done in 1965.”

Another problem lawmakers must deal with is cost. Republican leader Trent Lott of Mississippi said GOP members were unwilling to spend more than the $370 billion in the Republican-backed proposal.

“I don’t see us being able to move above that,” he said.

Lott suggested that the Senate craft a plan that helps the neediest seniors, but that proposal may have trouble gaining traction. Democrats have insisted on a universal benefit that is available to all of the nation’s elderly.