Senate Prepares to Vote on Scaled-Back Medicare Drug Benefit Plan

The Senate could vote as early as July 30 on a compromise Medicare prescription drug benefit bill that would provide coverage for low-income beneficiaries and those with "catastrophic" costs, the Boston Globe reports. The legislation, sponsored by Sens. Bob Graham (D-Fla.) and Gordon Smith (R-Ore.), would provide comprehensive prescription drug coverage for Medicare beneficiaries with annual incomes up to 200% of the federal poverty level, or $23,880 for a couple. In addition, the measure would provide complete drug coverage for beneficiaries after their annual out-of-pocket prescription drug costs exceed $3,300. Medicare beneficiaries who do not qualify for comprehensive coverage would receive a 5% federal subsidy (Kirchhoff, Boston Globe, 7/30). They would also receive a pharmacy discount card, which could offer annual savings of 20% or more on medications (Hook, Los Angeles Times, 7/30). Under the bill, all but low-income Medicare beneficiaries would have to pay a $25 annual enrollment fee to receive prescription drug coverage. Beneficiaries would not have to pay monthly premiums or deductibles. The legislation would cost an estimated $395 billion over 10 years ( AP/Baltimore Sun, 7/30). "It's a significant down payment, which will help millions of senior citizens who need help the most and protect all senior citizens against catastrophic drug costs," Sen. Edward Kennedy (D-Mass.) said (Heldt Powell, Boston Herald, 7/30).

Republican Support?
The Graham-Smith bill, supported by a number of Senate Democrats, marks a divergence from Democrats' long-held belief that Medicare benefits should be universally available -- a "significant concession" that Democrats hope will attract Republican support for the legislation, which requires 60 votes for passage under Senate rules, the Los Angeles Times reports. However, some Republican senators criticized the bill as "too little coverage for too much money" (Los Angeles Times, 7/30). "It's another partisan poison pill. ... It leaves most of our seniors out in the cold, does nothing to contain increasing drug costs and carries an all-too-expensive price tag," Sen. Charles Grassley (R-Iowa) said (Boston Globe, 7/30). Senate Minority Leader Trent Lott (R-Miss.) added that Republicans will not support a Medicare prescription drug benefit bill that costs more than $370 billion over 10 years (MacDonald, Hartford Courant, 7/30). A Senate GOP aide said that "only a handful" of Republicans would consider the Graham-Smith bill (Fulton, CongressDaily/AM, 7/30). AARP is supporting the Graham-Smith bill. AARP Director of Policy and Strategy John Rother said, "We would certainly prefer a more comprehensive approach, but those failed to get the 60 votes, primarily because of the cost. It seems to us that doing something that helps the people most in need first does make sense, so long as it gives us something to build on moving forward" (Boston Globe, 7/30).

NPR Coverage
NPR's " Morning Edition" on July 30 examines the Graham-Smith bill and features comments from Graham and Rother (Rovner, "Morning Edition," NPR, 7/30). The report will be available online in RealPlayer after noon ET. Expanded NPR coverage of the Medicare prescription drug benefit debate is available online.