Congressional Budgets for Medicare Reform Sends Signal That Bush Plan Is Not ‘Realistic,’ CQ’s Goldreich Says

Although the House and Senate budget resolutions under consideration this week "reflect competing priorities," they "far outbid" President Bush's proposal to spend $190 billion over 10 years to overhaul Medicare and create a prescription drug benefit for seniors, Congressional Quarterly senior reporter Samuel Goldreich says in this week's "Congressional Quarterly Audio Report." The House plan would allocate $350 billion over 10 years for a senior drug benefit and Medicare overhaul, while the Senate proposal, to be written March 20, could set aside up to $500 billion. Goldreich notes that whatever legislators decide to spend on Medicare, it is "unlikely to mean much" once Congress has to appropriate and authorize the money later this year. However, Goldreich says the debate is significant because it puts Congress on record as telling Bush "he's not being realistic" about his Medicare plan. The most recent projections from the Congressional Budget Office show that national spending on prescriptions for Medicare beneficiaries over the next 10 years will reach $1.8 trillion, about 10 times more than what Bush has proposed for Medicare reform and a drug benefit. Goldreich reports that, realistically, White House budget planners do not expect to have a Medicare drug benefit in place before 2006 and will only do so if the economy rebounds from the recession "fast enough and strong enough" that Congress can avoid using the Social Security and Medicare trust funds to balance the budget.

Help for the Uninsured?
As for legislative action to reduce the number of uninsured, Goldreich predicts there will be "nothing but talk" this year. Democrats and Republicans have not reached a compromise between using tax credits and increasing public funding for Medicaid and CHIP programs. Goldreich adds that the coalition of insurer, consumer, labor, employer and health provider groups that earlier this year launched a $10 million advertising campaign to reduce the number of uninsured will face the "same issues that divide lawmakers." Goldreich says that the "best hope for progress" might result from "side negotiations" between the Chamber of Commerce and the AFL-CIO, which both have members that operate health plans (Goldreich, "Congressional Quarterly Audio Report," 3/18).