Baucus remains loyal to drug bill but criticizes its implementation

As one of only two Democratic authors of the controversial new Medicare prescription-drug benefit, Sen. Max Baucus (Mont.) must walk a fine line when  criticizing the program.

The congressional Democratic leadership has called for wholesale changes to the program, or even scrapping it entirely. Democrats also clearly believe Medicare is a winning issue for the upcoming election campaigns.

Baucus, meanwhile, has focused his criticisms on the Bush administration’s implementation of the benefit.

A Democratic leadership aide acknowledged that Baucus is out of sync with the caucus on Medicare. That has not stopped him from joining fellow Democrats in hammering the administration, however.

Baucus even joined Minority Leader Harry Reid (D-Nev.) on a letter to President Bush last week calling on the White House to take immediate action on Medicare. The letter also noted that Democrats have introduced bills to change the program.

“Senator Reid values very highly the leadership and expertise of Senator Baucus” when it comes to Medicare issues, a Reid spokesman said.

As ranking member of the Finance Committee, Baucus and then-Sen. John Breaux (La.) were the only Democrats who participated in the talks that led to the creation of the drug benefit. Baucus and Breaux sat in on months of meetings with Republican lawmakers and administration officials that other Democrats were not permitted to attend. Breaux has since left Congress.

“[Baucus] felt it was very important for him to be in the room,” said Carol Guthrie, his spokeswoman.

A handful of Republican members of Congress have also begun to grumble about the rollout of the drug benefit after hearing various complaints from their constituents over the winter recess — everything from criticism that the plan is too complicated to complaints that pharmacies had turned seniors away or overcharged them. Some have even introduced or called for legislation to address some of the problems that have emerged during the benefit’s first weeks.

Baucus’s support was crucial to the passage of the bill in 2003. Having a staunch Democratic backer gave the bill an element of bipartisan legitimacy and made it easier for other moderate Democrats to vote for the plan to provide medicine to senior citizens.

“Couldn’t have happened without him,” said Tom Scully, who ran Medicare during the debate on the bill.

Baucus has remained loyal to the law he helped create, although he has heaped harsh criticism on the agency charged with putting it in place. He has demanded details about how the White House, the Department of Health and Human Services and the Centers for Medicare and Medicaid Services (CMS) plan to address the difficulties many beneficiaries have encountered.

“Senator Baucus’s concerns have been consistent throughout,” Guthrie said. He has been in regular communication with administration officials since the bill was enacted and has warned them of the potential pitfalls awaiting implementation, she said.

“Against his strong advice, the benefit has been implemented in a way that is far too complicated,” she said. Like many lawmakers, he also has been “hearing from folks back home,” she added.

Baucus targeted the president after the State of the Union address Tuesday night in a written statement, saying Bush “utterly ignored the healthcare elephant in the room: the problems our seniors are having with the new Medicare drug benefit.”

So far, he has stopped short of calling for new legislation, unlike his Democratic colleagues. That could change if he is not satisfied with the plans conceived by the administration, said an aide present during a recent conversation between Baucus and CMS Administrator Mark McClellan.

Baucus passed up his most recent opportunity to back a fundamental change in the drug benefit. He voted against an amendment by Sen. Olympia Snowe (R-Maine) to the budget-reconciliation bill that would have granted HHS the authority to negotiate prices directly with drug suppliers. Current law grants that responsibility to the private health-insurance plans that provide the drug coverage to beneficiaries.

“It does indicate his desire to stick with the structure of the plan that was agreed upon,” Guthrie said.