By Lisa Seachrist
WASHINGTON - In the wake of House Republicans announcing a bipartisan plan for a prescription drug benefit, the debate over providing such a benefit hit a new level of rancor at a House hearing Wednesday.
On Tuesday, Reps. Bill Thomas (R-Calif.), Richard Burr (R-N.C.), Thomas Bliley (R-Va.) and Ralph Hall (D-Texas) announced they would be introducing legislation to provide the benefit to the nation's seniors based largely on subsidizing private insurance plans. However, the congressmen didn't give the specific details of their plan or provide the legislative language of their bill.
That omission served as the basis of the discord at a hearing of the House Commerce Committee's Subcommittee on Health and Environment, where Democrats and Republicans alike questioned how the full House would be in a position to vote on the proposal next week.
"This is way too important an issue to move without a full vetting in committee," said Rep. Greg Ganske (R-Iowa). "It would be a tragedy to pass a bill that Congress doesn't even understand. I just can't support a bill that is presented this way."
The Republican proposal focuses mainly on low-income seniors and subsidizing insurance companies that provide prescription drug coverage. The plan also would provide a stop-loss provision to help seniors with the highest drug costs, a measure considered critical by the biotechnology industry.
"My colleagues and I have been working on legislation that provides all seniors access to affordable, private drug coverage. We will be introducing legislation soon," Bliley said in a statement. "We have a good bill which can and will draw bipartisan support. I hope to work with our Democratic colleagues and the administration on this proposal."
President Clinton has offered a plan to create a Medicare Part D to provide a prescription drug benefit that would be administered through the Health Care Financing Administration (HCFA) in conjunction with private pharmacy benefit managers. The plan would contain a stop-loss provision starting in 2006. HCFA Administrator Nancy-Ann DeParle said the president's plan was based on several key principles that any benefit must ensure: it must be voluntary and accessible, affordable, competitive, consistent with broader reform and ensure access to needed medicines while encouraging high-quality care.
"We're encouraged by the new commitment the Republican leadership has shown with this new plan," DeParle said. "But, it does not appear to meet the president's key principles."
Democratic members of the subcommittee were more skeptical of the Republican proposal.
"Mr. Chairman, I'm glad we have been given the opportunity to discuss the need for Medicare prescription drug coverage today," said Rep. Sherrod Brown (D-Ohio). "However, I'm concerned that the Republican proposal that prompted this hearing is being taken seriously, when frankly it shouldn't be. How can you try to convince seniors that you're helping them, when the only thing you have promised to seniors is a low-income subsidy?"
Key to the Democrat's opposition to the Republican plan, aside from the fact no legislative language currently exists, is the fact that the plan relies on insurance companies creating a drug-only benefit for senior citizens.
"Seniors who thought they were financially secure are watching their savings go straight into the pockets of drug makers," Brown said. "And you are trying to tell seniors there will be a choice of reliable, affordable, private prescription drug insurance plans available to them. Based on what? Certainly not history. Even the insurance industry is balking at the idea."
Charles Kahn, president of the Health Insurance Association of America, concurred with Brown, noting his organization prefers a plan that would include a prescription drug benefit in the context of wider Medicare reform with block grants to states and tax credits to seniors to offset the cost of drugs in the meantime.
"Some of the proposals we have examined that rely on 'stand-alone' drug-only insurance policies simply would not work in practice," Kahn said. "Designing a theoretical drug coverage model through legislative language does not guarantee that private insurers will develop that product in the market."
"Sadly, it appears the effort is not as bipartisan as we would like it to be," said Rep. Gene Green (D-Texas). "This issue is going to be an election year issue whether it should be or not."
As the debate over the best way to provide a prescription drug benefit for senior citizens continues, it becomes less likely that any one plan will take hold with a limited number of legislative days remaining in Congress.