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Despite Obstacles, GOP Prescription Drug Bill Passes

Benefits: House Democrats say the measure falls short of guaranteeing coverage to senior citizens. Some Republicans criticize creating an entitlement.


WASHINGTON — The Republican-controlled House early today approved long-awaited legislation to help senior citizens meet the soaring costs of prescription drugs--a pressing concern that has become an important issue in this year's midterm elections.

The bill was passed, on a 221-208 vote. Despite broad support for the idea of providing new drug subsidies, the GOP measure faced a surprisingly tough fight. It was bitterly opposed by Democrats, who said it did not go far enough to guarantee coverage. Some Republicans, meanwhile, warned that the bill would go too far in establishing a costly government entitlement.

GOP leaders had vowed to pass the bill before Congress adjourned for its weeklong Fourth of July recess. They worked into the night Thursday, twisting arms and cutting deals to win support from recalcitrant Republicans.

Their victory came in the early morning hours today, when 212 Republicans were joined by eight Democrats and one independent in supporting the bill. Only eight Republicans defected and opposed the bill, joining 199 Democrats and one independent.

Attention now shifts to the Democrat-controlled Senate, where leaders plan debate on a more generous version of the drug benefit bill next month.

"We need action, not words, because America's greatest generation cannot wait any longer for help on their prescription drug bills," said House Speaker J. Dennis Hastert (R-Ill.).

If it were to become law, the bill would mark the biggest expansion of federal health subsidies for senior citizens since Medicare was created in 1965. The Senate is scheduled to take up its version of the legislation next month. But lawmakers say prospects for enactment are slim because of the vast differences between the parties over how to provide the new drug benefit--and the heavy political pressures against compromise in this election year.

Just as they did when Medicare was established, Democrats favor providing guaranteed benefits through the federal government, while Republicans want to offer subsidies through the private sector.

The political stakes are significant: Democrats have made a campaign issue out of their support for a more generous prescription drug benefit under the Medicare program. Republicans worry that unless they pass some version of their own, they will be vulnerable to charges of neglecting the most significant concern of senior citizens, who vote in large numbers and wield disproportionate political clout in off-year elections. "The battle for a drug benefit is an incredibly important subcomponent of Republican success in this cycle," said GOP pollster Bill McInturff.

The issue is already woven deeply into the fabric of House and Senate campaigns around the country. Some Democratic candidates in Northern states have highlighted the issue by staging bus trips to Canada, where prescription medication is less expensive. The issue is dominating the Senate race in Maine, where GOP Sen. Susan Collins is being challenged by Chellie Pingree, a state legislator who sponsored a state prescription drug program.

"Make no mistake, there is one thing standing between senior citizens and affordable prescription drugs: Republican control of the House of Representatives," said Rep. Martin Frost (D-Texas).

Republicans have worked hard to neutralize the issue by blurring differences between the parties. For the Memorial Day recess, the House leadership sent lawmakers home armed with briefing papers, PowerPoint presentations and instructions to hold town meetings on the GOP plan. Drug companies, which support the GOP approach, have financed television ads praising House Republicans who are running for reelection.

The cost of medicine has emerged in recent years as a major issue because prices have gone through the roof.

According to Families USA, an organization favoring a drug benefit, the average annual cost of prescriptions for seniors more than doubled between 1992 and 2000, from $558 to $1,211.

Prescription drugs are not covered by Medicare, the federal health insurance program for senior citizens and the disabled, in part because they were not as big a part of health care in 1965 as they are now--especially in the treatment of chronic diseases.

The GOP bill would cost $350 billion over 10 years, including about $310 billion for drug coverage. The rest of the money would go to raise payments to hospitals, health maintenance organizations, doctors and others who care for Medicare patients.

Under the GOP plan, the new drug benefit would be provided not through Medicare, but through subsidies to private insurers that offer benefits. Beneficiaries would pay premiums of $33 a month and have a deductible of $250 a year--although those fees would be paid by the government for the poor.

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