Lawmakers Trade Proposals, Attacks On Drug Benefits

By Amy Goldstein
Washington Post Staff Writer
Thursday, May 2, 2002; Page A04

Election-year politics precipitated a slugfest in Congress yesterday over how to help elderly Americans afford prescription drugs, with Republicans and Democrats trading ideas and accusations -- even though neither party has produced a bill this year on the popular but expensive issue.

Sen. Bob Graham (D-Fla.), announced that he soon would introduce a new version of prescription drug legislation he has championed for the past two years, featuring changes that would give bigger subsidies to patients but make the plan more expensive for the federal government.

That modest announcement prompted the Republicans to make maneuvers of their own. House Speaker J. Dennis Hastert (Ill.) pledged from the Capitol steps to pass a prescription drug bill this month. Republicans previewed the outlines of the legislation. And the White House circulatedto GOP lawmakers a rapid response they could use to denounce Graham's proposal.

In turn, Senate Majority Leader Thomas A. Daschle (D-S.D.) and House Minority Leader Richard A. Gephardt (D-Mo.) branded GOP commitment to providing a drug benefit as inadequate. "Democrats are going to be pursuing this very aggressively," Daschle told reporters, predicting the Senate would adopt a bill by August.

Such intense jockeying reflects the high stakes that both parties attach to the way voters perceive their willingness to offer drug benefits to the elderly. The issue has become prominent at a time when pharmaceutical prices are the most rapidly increasing part of the nation's health expenditures and more than one-third of elderly Americans have no health insurance that helps pay for medicine.

For the past few years, legislation that would add drug coverage to Medicare, the federal insurance program for Americans 65 and older, has bogged down over complex disagreements about how a benefit should be designed and how the government could afford to pay for it.

This year, with disagreements as deep as ever, Republicans and Democrats are trying to portray themselves as the party most eager to pass a bill. In addition, both parties indicated yesterday that they will promote proposals this year that would give elderly people larger subsidies than previous legislation would have provided, even though recent federal surpluses no longer exist. That increased generosity is a response to polling data that have suggested elderly people want more financial help than Congress has considered giving them in the past.

Graham said his plan would require elderly people to pay an insurance premium of $25 a month, less than half the premium envisioned under earlier versions of his bill. It would also eliminate a $250 deductible he had proposed. It would pay at least half of people's drug expenses, to a maximum of $4,000 a year, and all of the drug costs for the small number of people whose expenses are higher than that amount. Aides said the plan would cost an estimated $425 billion during its first six years, while earlier Graham legislation would have cost about $375 billion over a decade.

In contrast, House Ways and Means Committee Chairman Bill Thomas (R-Calif.) said the House GOP legislation, which is being crafted, probably would charge a premium of $35 to $40 per month and include a $250 deductible. It probably would pay 75 percent of people's drug costs up to $1,000, then half the costs up to a limit of $2,250. People would not be subsidized beyond that amount, unless their expenses exceeded $4,000 or $5,000 a year. The plan would cost $350 billion.