Fearing Senior Backlash, Senate Supports Drug Plan Extension

The Republican-led Senate, worried that seniors will punish GOP lawmakers at the polls for missteps in the new Medicare prescription drug program, voted Wednesday to authorize the government to lengthen the sign-up period for the benefit and to negotiate cut-rate prices with drug companies.

The Senate action provided fresh evidence that the prescription drug insurance program, which President Bush has held up as one of the leading achievements of his presidency, had turned into a political liability.

The vote to allow the government to negotiate for discounts on drugs marked a major policy reversal for the Senate and a rare move against the pharmaceutical industry, one of the leading donors to federal political campaigns, with most of its money going to Republicans. Negotiations for drug discounts were barred under the 2003 law that created the drug benefit.

The Senate action does not carry the force of law because the amendments were attached to a budget resolution that provides only guidance for future legislation. But it carries political significance by putting the administration on notice that it cannot depend on routine approval by Congress to carry out the drug program.

The votes came as Bush, who has acknowledged the widespread confusion among seniors over the new benefit, felt the sting of seniors’ unhappiness as he faced sharp questions about the program Wednesday during a visit to a Maryland senior center. The trip was intended to promote the drug benefit and to encourage seniors to sign up before May 15. After that date, they will have to pay a surcharge in order to enroll.

Bush said he was committed to keeping the May 15 deadline. “There’s got to be a fixed time for people to sign up,” he told one audience member who had complained that her sick mother needed more time. “We want people to realize there is -- now is the time.... Rolling back deadlines is not going to help your mom make a good decision.”

Democrats have argued for weeks that the government should extend the enrollment period, given the confusion over how to sign up and the widespread problems that have left many who enrolled unable to get their prescriptions filled or paid for.

And Democrats have long said that the government, which spends billions of dollars annually on pharmaceuticals through Medicare, ought to be able to negotiate with drug companies for volume discounts, as other big customers do.

But it took until Wednesday for enough Republicans to agree and for the Senate to take action.

The vote authorizing Medicare to negotiate on prices, much as private insurers do, was a particularly bitter pill for the administration, which has consistently sided with drug companies against negotiated price levels.

“The rapidly escalating price of prescription drugs threatens to undermine the very drug benefit Congress passed to deliver real savings to seniors,” said Sen. Olympia J. Snowe (R-Maine), a sponsor of the provision to authorize price negotiations. “Our amendment manages costs in a common-sense way -- harnessing the buying power of millions of seniors to give them a better value for their healthcare dollar.”

Sen. Ron Wyden (D-Ore.), the other sponsor, said over and over: “This is not price controls.”

Drug companies disagreed.

Ken Johnson, senior vice president of Pharmaceutical Research and Manufacturers of America, the industry trade association, said drug companies were already negotiating prices -- not with the government, but with the hundreds of prescription drug plans offering to insure Medicare recipients.

The roll-call vote for the provision was 54 to 44. California’s two Democratic senators, Barbara Boxer and Dianne Feinstein, voted with the majority.

Wyden’s office said inclusion of the language in the congressional budget resolution would make it easier to pass subsequent legislation forcing the government into price negotiations -- assuming similar language is in the House budget resolution and is not stripped out in a conference committee.

If the language is not in the final version of the budget resolution, 60 votes would be required to pass any legislation related to it; if it is, 51 votes would be necessary.

The pharmaceutical industry is among the most generous contributors to both parties. Since 2000, drug companies have given more than $70 million, the vast majority to Republicans, according to the Center for Responsive Politics.

On the issue of extending the enrollment period for the drug program, the Senate voted 49 to 49 to defeat a proposal to give seniors until the end of the year to enroll without penalty. Sen. Charles E. Grassley (R-Iowa), chairman of the Senate Finance Committee, called the proposal a “cynical attempt” to induce seniors to wait a year before entering the program.

The Senate instead voted 76 to 22 for Grassley’s alternative, which gives the administration the authority to extend the deadline beyond May 15.

Bush’s appearance Wednesday in Silver Spring, Md., marked the second time in two days that he had conducted a town-hall-style discussion with seniors and their advocates about the program. The appearances were designed to soothe potential political fallout stemming from the program’s rocky beginning.

On both occasions, Bush conceded that people were confused by the program. And in a sign of the troubles the president and other Republicans could face in an election year, some of the exchanges were confrontational, and Bush grew defensive.

When the woman who asked about extending the deadline pressed further, wondering whether officials planned to reach out to confused seniors, Bush offered stern advice: Don’t count on the government’s help for everything.

“I happen to think -- and I don’t want -- look, I’m not going to tell you your business, but I think it’s your responsibility to help your mom, and I think a lot of parents -- a lot of children should help their moms,” Bush said to scattered applause.

One man confronted Bush about Richard S. Foster, a Medicare analyst who said he was threatened with firing in 2003 if he disclosed to Congress that the White House-backed drug plan would probably cost as much as $200 billion more than the administration had predicted. Democrats seized on his case during the 2004 elections, citing it as evidence that the White House was manipulating the facts and was overly secretive.

“Did that man speak the truth?” the audience member asked Bush. “And if so, why would you not want facts like that to come out to the American people?”

Bush responded that “the estimated cost is 20% lower” than what was forecast.

“And the reason why is because the program has worked better than anticipated,” Bush said. “Well, they estimated, for example, the average premium was going to cost $37 a month, and it’s down to $25 a month. In other words, it’s working.”