‘Substantial’ Medicare Prescription Drug Benefit Unlikely Following Attacks

Several "crucial" lawmakers and health policy analysts say that Congress will likely "defer" the "long-sought, long-promised" Medicare prescription drug benefit "again" this year, the New York Times reports. A prescription drug benefit "seemed doable" earlier this year but has "gradually slipped out of reach" amid an "economic downturn," the Bush administration's 10-year, $1.35 trillion tax cut and increased spending in the aftermath of the Sept. 11 attacks on the World Trade Center and the Pentagon. "It's probably not going to happen this year, and if it happens next year it may be only in a token fashion," Robert Greenstein, executive director of the Center on Budget and Policy Priorities, said. Asked about the future of a prescription drug benefit this year, Sen. John Breaux (D-La.) said, "R.I.P." Congress has "struggled" with a prescription drug benefit for more than three years, finding it to be a "complex" issue that "touches on some of the deepest philosophical divisions" between Republicans and Democrats about the role of government.

Chances 100% in 2002?
The New York Times reports that "history suggests that once a political moment passes for health care proposals, a long time can pass before another comes." However, Reps. Benjamin Cardin (D-Md.) and Nancy Johnson (R-Conn.) said that a prescription drug benefit for seniors "will not fade away." Johnson said, "Next year, the chances are 100%. We are definitely going ... ahead, no question about it. It may have to be a more graduated program that takes into account need. But, frankly, we have to do it." Cardin said, "We have missed our moment, but ... I think we can get it in the next year or two," adding, "Seniors are angry." According to Patricia Neuman, a vice president of the Kaiser Family Foundation, "The reason I'm not prepared to close the window [on a prescription drug benefit] is that it's seniors. They vote, they go to town meetings and it's a real issue for them." However, the New York Times reports that next year, lawmakers may face a "brutal combination" of recession, "intense budgetary constraints" and the "pressures" of an upcoming election, which could hinder a prescription drug benefit.

Discount Card 'Avoidance'?
Centers for Medicare and Medicaid Services Administrator Thomas Scully said Friday, "Seniors want a drug benefit, and we certainly want to make sure that, especially, needy seniors get one." He added that the administration hopes to implement a pharmacy discount card program that President Bush unveiled in July (Toner, New York Times, 11/5). Under the plan, the federal government would approve discount cards issued by pharmacy benefit managers, which would use the purchasing power of Medicare beneficiaries to negotiate with pharmacies and drug makers to reach discounts of between 15% to 25% off of drugs' retail prices. A federal judge issued a temporary injunction against the plan in September in response to a lawsuit brought by pharmacist groups alleging that the administration lacks the authority to implement the plan without congressional approval and violated federal rules by drafting the plan without open meetings or a public comment period. The Bush administration plans to appeal the decision (Kaiser Daily Health Policy Report, 9/20). Democrats and advocates for seniors "fear" that the administration will use the plan as an "avoidance technique" to "ease the pressure for a real" prescription drug benefit (New York Times, 11/5).