Senate Kills Prescription Drug Bill

A much-heralded drive to provide the elderly with prescription drug coverage died in the Senate on Wednesday, likely putting the legislation on hold until the fall elections determine whether either party can gain the upper hand in shaping policy after 2002.

Once-high hopes that Congress would enact a prescription drug benefit this year were dashed when the Senate voted, 50 to 49, against a last-ditch compromise. The Democratic leaders who control the Senate then pulled the plug on a debate that had stretched over more than two weeks.

Some proponents clung to hope that the push for prescription drug coverage could be revisited soon if enough senior citizens rise up and lambaste senators for their inaction.

“It’s never too late to do the right thing,” said Bill Novelli, head of the AARP, the senior citizen’s group that plans to continue its heavy lobbying to end the Senate stalemate.

But others predicted that Wednesday’s vote was likely the Senate’s last word on the issue this year. “This is probably our last, best chance to pass a prescription drug benefit in [this] Congress,” Sen. Gordon Smith (R-Ore.) said of the compromise plan he helped write.

The Senate, having shelved several alternatives for providing drug coverage in recent votes, passed a more modest but important measure to help curb the cost of medicine. It voted, 78 to 21, for a bill to make it harder for brand-name drug companies to block the marketing of cheaper generic versions.

Although the Senate’s debate on drug coverage was inconclusive, it may not be for naught. Some believe a path to future compromises has been opened because both parties took major steps away from their traditional positions.

Democrats for the first time significantly scaled back their most ambitious plans for universal drug coverage. Republicans embraced a bigger expansion of a government entitlement program than the party traditionally has supported. The two parties even seemed to reach consensus on the price tag: By the debate’s end, both Republicans and Democrats were backing alternatives that would cost roughly $400 billion through 2012.

But prospects for compromise broke down on stubborn philosophical differences--not over spending but over the role of government. Democrats, preferring the stability and uniformity of a government-run program, wanted the coverage delivered through Medicare, which provides benefits to those 65 and older and to the disabled. Republicans preferred relying on the private sector to deliver drug coverage to Medicare beneficiaries, arguing that competition among insurance companies and health maintenance organizations would be more efficient than government in controlling costs.

Wednesday’s final vote on the issue came on a compromise that would have targeted drug benefits to elderly people who are poor or face very high drug costs. It would have cost $390 billion through 2012 and would be delivered through the Medicare program.

The vote broke largely along party lines: four Republicans joined 45 Democrats in voting for the bill; 44 Republicans, five Democrats and one independent voted against it. California’s senators, Democrats Barbara Boxer and Dianne Feinstein, both voted in favor of the compromise.

Last week, the Senate rejected a Democratic proposal that would have cost $594 billion through 2012. Also failing was a GOP plan totaling $370 billion over the same period. Both fell short of the 60 votes needed to clear a crucial Senate procedural hurdle.

A bill passed earlier this year by the GOP-led House would provide about $310 billion for drug coverage over 10 years.

Senate Democrats said they were pleased their bill drew 52 votes--more than any other alternative. “It’s inevitable that we’re going to pass it; it’s just a question of when,” said Sen. Edward M. Kennedy (D-Mass.).

Even the Republican alternative--which won 48 votes--would have represented the biggest expansion of benefits for Medicare recipients since the program was established in 1965.

Indeed, the Senate debate made clear that there is a broad consensus that something needs to be done to help the elderly cope with drug costs. Almost every senator voted for one or another of the various drug-coverage alternatives.

But the stalemate is characteristic of how hard it is to work out the details of a major new social program with Congress so narrowly divided between the two parties. Republicans control the House by a handful of votes; Democrats rule the Senate by one seat.

When Congress enacted Medicare, by contrast, Democrats controlled the Senate by a 36-seat margin and the House by a 155-seat margin.

Many Democrats plan to use the stalemate over drug coverage to make the case to voters that they should elect more Democrats to Congress.

“Democrats control the Senate, but they don’t control it by enough votes,” said Tovah Ravitz-Meehan, spokeswoman for the Democratic Senatorial Campaign Committee. “That becomes a rallying cry for us: If we have reinforcements, we can finish these and other domestic issues.”

Similar arguments will be made by Democrats about House races.

The GOP’s political sensitivity to the drug issue was apparent in Wednesday’s roll call vote on the compromise. Three of the five most vulnerable Republicans facing re-election this November voted for the compromise: Smith of Oregon, Tim Hutchinson of Arkansas and Susan Collins of Maine. Collins’ Democratic opponent has made the issue the centerpiece of the bid to unseat her.

But Republicans believe the Senate stalemate gives them fresh ammunition for defending their record on an issue that is traditionally Democratic turf. They are stressing that the House--the chamber they control--passed a prescription drug plan, while the Senate did not.

“It’s going to be pretty hard to blame it on someone else when you are in charge,” said Senate Minority Leader Trent Lott (R-Miss.).

The National Republican Senatorial Committee has already aired radio ads criticizing Sen. Max Baucus (D-Mont.) chairman of the Senate Finance Committee, for failing to pass a prescription drug bill. “Max Baucus, he’s all hat and no cattle!” the ad said.

The Bush administration, while not taking a prominent role in the debate, was quick to criticize the Senate for failing to act. Press Secretary Ari Fleischer said, “Seniors once again will have to continue to wait for long overdue prescription drug coverage.”

Some analysts agree that the Senate debate may make it harder for Democrats to use the issue against Republicans.

“Now you have the situation where everybody can go home and say they voted for a prescription drug bill,” said Tricia Neuman, vice president of the Kaiser Family Foundation. “It’s very difficult for voters to understand the differences between these proposals.”

But political risks may face incumbents of both parties. John Rother, of the AARP, said senior citizens are clearly running out of patience with inaction on the drug issue. “Our members are not going to accept finger pointing. We’re not going to accept stalemate. We’re not going to rest until this thing is done this year.”

Robert Blendon, professor of health policy at Harvard University, said he believes Congress will have to find a way to act before voters go to the polls in 2004.

“The issue has sufficient staying power; it’s not going to go away,” said Blendon.