WASHINGTON — New and much higher cost estimates for Medicare's drug benefit touched off a storm of concern in Congress on Wednesday, potentially complicating President Bush's ability to persuade lawmakers to support his plans for tax cuts and Social Security overhaul.
"This just brings us back to the Bush administration's credibility gap," said Rep. Charles B. Rangel of New York, the senior Democrat on the House Ways and Means Committee, which oversees Medicare. "How can we trust them on Social Security when they did not play straight with the facts on Medicare?"
Some observers who usually support the White House concurred. "It's going to cast a trillion-dollar shadow over the conservative agenda," said Robert Moffit, a health policy analyst with the Heritage Foundation, a conservative research center in Washington. "It's going to be harder to preserve the tax cuts and make them permanent."
The White House, however, insisted that the problem was not due to an unexpected surge in the cost of the drug benefit, but merely reflected confusion over accounting methods.
The new figures for the benefit, which is to take effect in 2006, were included in the budget Bush sent Congress on Monday.
Medicare administrator Mark McClellan said the prescription benefit was now projected to cost nearly $724 billion over the 10-year period, from 2006 through 2015.
The figure is far higher than the $400 billion the administration estimated in 2003, when Bush was lobbying for the benefit in the face of sharp objections from fiscally conservative Republicans -- and higher than the revised estimate of $534 billion given two months after the legislation had passed.
But the previous estimates were for a different time period, from 2004 to 2013. That earlier window includes two years of minimal cost to the government -- 2004 and 2005 -- before the benefit takes effect.
"Now ... we are looking further out into the future when there are more Medicare beneficiaries getting more assistance," McClellan said. "And that is the only real source of changes."
Nearly 37 million beneficiaries are expected to enroll in the voluntary drug benefit next year; by 2015, that figure should reach nearly 46 million. They will purchase coverage through private plans; the government will subsidize premiums.
