Administration officials look to ease GOP concerns on Medicare

Senate Republicans met with senior Bush administration officials in private yesterday afternoon to discuss their concerns with the Medicare prescription-drug program and to prepare for the escalated Democratic attacks on the program expected next week during the recess.
 
Democratic leaders and strategists last week had urged lawmakers to launch a barrage of criticisms against the drug program.

About 30 Republican lawmakers sat down with Mike Leavitt, the secretary of the Department of Health and Human Services, and Mark McClellan, the administrator for the Centers for Medicare and Medicaid Services (CMS).

Lawmakers, according to a senator in attendance, asked the officials about two major criticisms of the drug plan, which was the legislative centerpiece of President Bush’s first term: that the drug plan offers too many programs and as a result is too confusing for seniors, and that it has a hole in a coverage. Drug costs between $2,250 and $5,100 a year are generally not covered by the program.

Senior senators such as Pete Domenici (N.M.) and Larry Craig (Idaho) said the program is fundamentally sound and will help many senior citizens.

Administration officials gave the lawmakers promising statistics about the program: 24 million of the 42 million eligible participants have signed up, 250,000 seniors sign up each week and the monthly individual premium cost has dropped from $37 to $25 per month, according to a lawmaker who took notes during the meeting.

However, Democrats note that many of the seniors who have “signed up” were automatically enrolled or have long been part of an employer-sponsored program.

Leavitt and McClellan also reported that the administration is addressing the gap in coverage by sending out letters to enrollees alerting them when their medical costs are approaching a level that will exceed government coverage. The officials said that seniors approaching the so-called “doughnut hole” would have the option to switch plans to avoid the gap.

Some healthcare experts predict that many seniors will hit the doughnut hole right before the November elections.

Domenici called the bill a “giant step forward” and said, “When it works it’s going to help a lot of people.”

But he acknowledged “it’s too bad managementwise we haven’t got better assistance and put out better word.”

Nevertheless, he said he disagrees with Senate colleagues who are proposing a legislative fix to the program, advocating instead for administrative solutions.

“I’ve heard senators say, ‘See? It didn’t work. Let’s fix it,’” Domenici said. He said that “every management tool should be used to smooth this over as best as possible.”

During the meeting, Craig offered a rebuttal to colleagues who said the program offers too many plans and is too confusing.

“My retort was: ‘You want one federal program, take it or leave it?’” he said.

Meanwhile, Leavitt is scheduled to meet with Presidcent Bush today.

One Republican senator who might support a legislated change to the program is Sen. John Ensign (Nev.), who voted against the drug plan because of its lack of what he called “cost containment.”

Ensign said he thinks Congress should “restructure the program and make it means-tested,” meaning that benefits would be based on the recipient’s ability to pay.

Senate Republicans are asking tough questions of administration officials to prepare for an expected Democratic assault on the prescription-drug program.

Last week, Democratic strategists Stan Greenberg, James Carville and Matt Hogan circulated a memorandum urging Democratic leaders and allies to focus their criticisms of the Republican Party on Medicare.

“Although the plan is already unpopular, Democrats now have the opportunity to raise opposition to the drug benefits to new heights and use the plan as a powerful symbol of Republican corruption and irresponsibility,” the strategists wrote. “Coupled with attacks over budget cuts to Medicare, an assault on the prescription-drug program could cause serious damage to the GOP, especially among seniors.”

The strategists reported that opposition to the plan among voters between 50 and 64 years old has risen from 38 percent to 51 percent since the fall and that voters 65 or older are opposed to the program by a 28-point margin.

A Republican Senate aide said that the Democratic tactics are a politically motivated effort to scare seniors away from signing up for a program that would help them.

Still, criticism of the administration’s handling of the benefit has come from both sides of the aisle. House Majority Leader John Boehner (R-Ohio) recently called the early implementation of the benefit “a disaster.”

House Democratic leaders circulated a “Dear Colleague” letter last week to Democratic lawmakers, urging them to hold public events, including town-hall meetings and visits to senior centers, criticizing the Medicare program.

The same day that Democratic strategists released their memo, House Minority Leader Nancy Pelosi (D-Calif.) held a town hall meeting in San Francisco charging that the Republican program has hurt seniors.

“Hundreds of thousands of Medicare beneficiaries across the country have been unable to get their needed prescriptions, have faced outrageous delays and have been overcharged,” Pelosi said.

Sen. Jay Rockefeller (W.Va.), the ranking Democrat on the Health Care Subcommittee of the Senate Finance Committee, said analysts predicted a few years ago that the Republican plan would encounter difficulties because of its complexity.

Rockefeller said that he has put together legislation that would address the problems by eliminating the gaps in prescription-drug coverage experienced by low-income seniors and the disabled. He added that several Democratic colleagues have drafted other plans but that the caucus has decided to wait to reveal a comprehensive party proposal on Medicare.

“The question is whether we come out with plans right now or let them vent,” he said, referring to internal squabbles with Republicans over the drug program. “If we came out with a plan right now, Sean Hannity would shred it,” referring to the conservative talk-show host and his allies on the right.

A senior Democrat said Democrats would wait until they are closer to Election Day.