Senior Drug Plans Killed

The Senate on Tuesday defeated two plans--one from each party--that would have helped the elderly pay for soaring prescription drug costs, leaving scant hope that the impasse on the issue will be broken this year.

In back-to-back votes, senators failed to approve either a Democratic plan to add a drug benefit to Medicare or a less-expensive Republican alternative that would rely largely on the private sector to provide the coverage. Either alternative would have represented the biggest expansion of government aid to the elderly since Medicare was established in 1965.

“This is a vote about national character and priorities,” said Sen. Edward M. Kennedy (D-Mass.), one of the few still in the Senate who served in 1965.

But neither alternative garnered the 60 votes needed under Senate budget rules. The vote for the Democratic alternative was 52 to 47; the GOP version failed to win even a bare majority, losing 48 to 51.

After the votes, key senators said they would go back to the negotiating table to see whether a compromise between the two measures could be cobbled together and passed in the next week. Most lawmakers, however, see only bleak prospects for crafting a measure that could clear the Senate.

“Unfortunately, I think it is not particularly likely,” said Sen. Robert Torricelli (D-N.J.). “The proper coalition still has not formed, and there are still too many differences.”

Sen. John B. Breaux (D-La.), who is central to efforts to draft a compromise, gave the enterprise no more than a 50-50 chance of succeeding. “It’s possible, but it’s no cinch,” he said.

Some Democrats have expressed growing anxiety that if Congress comes up empty-handed, lawmakers will suffer the wrath of elderly voters who are growing weary of politicians making promises on drug coverage that they fail to fulfill. “To go home without getting anything done is simply not an option,” said Sen. Zell Miller (D-Ga.).

But with an eye on the November elections, many Democrats intend to portray Republicans as the principal obstacle to enacting prescription drug coverage. Many Republicans are hoping they have neutralized the issue by backing a version of their own.

But some conservatives welcome the stalemate, saying even the GOP plan would be unaffordable at a time of burgeoning federal budget deficits. John C. Goodman, president of the National Center for Policy Analysis, a Washington-based think tank, said both parties are “engaged in a shameless bidding war to court elderly voters.” Enactment of either Senate proposal, he said, would “mortgage the future of our children and grandchildren.”

Some analysts say the Medicare issue may end up being less important to the 2002 elections than once may have been expected. That’s because the sense of economic insecurity prompted by the tumbling stock market and the threat of terrorist attack have come to dominate the political scene. “There are so many other issues on the agenda ... the stock market, terrorism, the war overseas,” said Robert Blendon, a professor of health policy at Harvard University.

The Senate may end up passing a narrowly focused measure to curb drug costs by making it harder for brand-name drug companies to delay bringing cheaper generic drugs to market. That generic-drug bill has served as the vehicle for a broader debate about providing a prescription drug benefit. Democratic leaders arranged for the major proposals to be offered as amendments to the bill.

The chief Democratic plan, whose sponsors include Kennedy and Miller, would cost an estimated $600 billion over seven years to provide a government-administered drug benefit through Medicare. GOP critics called it a budget-busting expansion of bureaucracy that’s unaffordable.

Most Republicans support an alternative that would cost $370 billion over 10 years. But rather than making the benefit part of Medicare, it would instead pay subsidies to private insurers that provide drug coverage to the elderly.

Democratic critics said the plan, like a similar one recently passed by the House, would leave too much to the initiative of private insurers and fail to guarantee that affordable benefits would be available throughout the country.

Lawmakers say it will be easier to reach a compromise on cost than it will be to bridge divisions over how the benefits should be delivered. That dispute pits the GOP’s preference for private-sector solutions and market competition against Democrats’ insistence on government-guaranteed benefits through Medicare.

One idea being discussed is to begin the program as a government-guaranteed benefit but gradually phase in a larger role for private insurers. Breaux expressed skepticism that such a blend was practical.

The split between the parties was evident Tuesday: The Democratic alternative was supported by 50 Democrats and two others: the Senate’s lone independent, James M. Jeffords of Vermont, and one Republican, Peter Fitzgerald of Illinois. Voting against it were 47 Republicans. The GOP alternative was backed by 45 Republicans, Jeffords and two Democrats: Breaux and Mary Landrieu of Louisiana. Opposing it were 48 Democrats and three Republicans.