WASHINGTON — Reminding Americans of his commitment to Medicare reform, President Bush called on Congress on Wednesday to "finish the work" of passing a prescription drug bill.
"After years of debate and deadlock, the Congress is on the verge of Medicare reform," Bush said.
The president's speech to an invited audience at the Dwight D. Eisenhower Executive Office Building was punctuated with well-worn arguments for modernizing the 38-year-old program that covers health care for 40 million senior and disabled Americans.
But with House-Senate negotiations all but stalled over the question of how to reform Medicare while covering prescription drugs rather than whether to do so, many said Bush's remarks would do nothing to move the process forward.
White House officials have signaled in recent days that while passage of a Medicare prescription drug benefit is important to Bush, whose public approval ratings on domestic issues have been slipping, the details of the legislation are not.
Yet it is the specifics of the Medicare legislation -- particularly its limited coverage of seniors' drug expenses, an emphasis on health-maintenance and preferred-provider organizations and a $400-billion, 10-year price tag -- that have spurred growing opposition to the legislation from a range of groups across the political spectrum.
The libertarian Cato Institute, the National Taxpayers Union and the Alliance for Retired Americans are among the groups that in recent days have begun running advertisements, writing letters to congressional leaders and issuing statements saying, in essence, that "no bill is better than a bad bill."
"It's important not to screw up Medicare," said Roger Hickey, co-director of the Institute for America's Future, a coalition of labor, consumer and seniors' groups.
Bush promised during his 2000 presidential campaign to make prescription drug coverage for seniors one of his top priorities. With Republicans controlling both houses of Congress, many GOP lawmakers also feel the pressure to deliver on a promise before next year's election campaigns get underway.
"I urge the Congress to act quickly, to act this year, not to push this responsibility to the future," Bush said. "We have the opportunity, we have the obligation to give seniors more choices and better benefits. We have come far, and now is the time to finish the job."
"He knows [passage of a prescription drug bill] is essential for him and for Republicans in Congress," said Ron Pollack, executive director of the consumer group Families USA. "But there needs to be a little banging of heads here, and that's not happening."
John Rother, director of policy and strategy for the 35-million-member seniors' group AARP, said, "It seems pretty clear that [Bush] doesn't want to get too engaged. But to the extent that these disputes are between House Republicans and Senate Republicans, he's the obvious referee."
But Senate Majority Leader Bill Frist (R-Tenn.) -- who, along with House Speaker J. Dennis Hastert (R-Ill.), may ultimately have to twist some arms to achieve a compromise -- said Bush's speech was helpful.
It shows that Medicare legislation "is a major priority for the president of the United States that the Congress must deliver on in the next several weeks," Frist said.
Several Democratic lawmakers complained that Bush had squandered an opportunity to "exert leadership" on the issue.
"The president restated today what we've all been saying for years: that seniors want and need a Medicare prescription drug benefit," said Senate Minority Leader Tom Daschle (D-S.D.).
Sen. Edward M. Kennedy (D-Mass.) criticized the president for framing the political issue as letting seniors choose between "the kind of coverage that works best for them" and "having that choice made by the government."
"The White House is obviously hoping America's seniors won't read the fine print," Kennedy said. "The president's proposal offers false choices to seniors that will raise their Medicare premiums and force them to join HMOs."
Members of the conference committee working to forge a compromise between the House and Senate bills passed in June said Wednesday that they still had not resolved issues concerning competition between traditional Medicare and private health plans, efforts to control Medicare spending, the importation of U.S.-made drugs from Canada and health savings accounts.
A bevy of smaller issues -- including higher Medicare premiums for wealthier seniors, a possible co-payment for home health care and how much to pay oncologists for administering certain cancer drugs -- also remain unresolved
"We've never had a single vote," said Sen. Charles E. Grassley (R-Iowa), co-chairman of the conference committee.
Times staff writer Maura Reynolds contributed to this report.