Bush's Medicare Rx
Hoping to turn the tables against Al Gore on health care, George W. Bush outlined his Medicare prescription drug plan Tuesday in a key battleground state.
"Keeping the promise of Medicare and expanding it to include prescription drug coverage will be a priority of my administration," said Bush, the Texas governor and GOP presidential nominee, at a senior center in Allentown, Pa.
For most people, the Bush plan would mean a government subsidy of 25 percent of the cost of the premium charged by a private insurer, putting the governor in the unlikely position of bragging about new government spending.
"I support new resources for Medicare," he said of his plan, which would be phased in over four years. "My budget will double funding for Medicare, from $216 billion to $441 billion, over the next ten years."
Bush emphasized his plan would give seniors coverage comparable to members of Congress, and he promised it would provide free prescription drugs to the poorest seniors right away, through the states. His so-called "Immediate Helping Plan" would spend $48 billion over four years for prescription drugs for individuals with annual incomes of $11,300 or less and couples whose incomes are $15,200 or less.
Bush also said Tuesday that he will restore $40.3 billion in Medicare funds cut by the 1997 Balanced Budget Act, bringing his ten-year Medicare spending plan to a total of $198.3 billion.
Bush called the Clinton-Gore administration a "roadblock to reform," saying they'd had eight years to do something about Medicare and "did not deliver."
The governor, who had spoken of his Medicare plans in more general terms until the Gore campaign smoked him out for specifics, said the vice president's plan would cover "no more than one half the cost of your prescription drugs."
True, said Marilyn Moon, a Medicare expert at the Urban Institute, but she added Bush's plan "will probably be worse than that," paying "substantially less than half."
Moon said the Bush plan is "better in the first year than the Gore plan, but after the first few years, it would always be worse than the Gore plan. You just can't get that much coverage for the subsidy he's talking about."
Speaking for the Gore campaign, Health and Human Services Secretary Donna Shalala said Bush's proposal would mean seniors everywhere would not necessarily get the same prescription drug coverage. "Under the Bush plan," she said, "there will be wide variations across the country."
Shalala also said that participation under the Bush plan would be "voluntary" for the states - and "if you live in a state that opts not to participate, you're left out in cold." The Cabinet secretary maintained that eligible seniors might not enroll in the Bush plan because of their skepticism regarding HMO's and reluctance to "go to a state welfare office to sign up."
Campaigning in Columbu, Ohio on Tuesday, Gore said the Bush plan "forces seniors into HMO's" and would leave "millions" without coverage. On top of that, the vice president said Bush cannot pay for his plan, given his proposed $1.3 trillion tax cut
Gore wants to spend an estimated $253 billion over 10 years to add a universal
prescription drug benefit to Medicare. The Bush campaign derides Gore's as a "one-size-fits-all government plan" that would take away choice.
Bush did not say how his Medicare changes fit into his overall economic plan, including the tax cut. "Under both [candidates plans]," said Moon, "these will get to be pretty expensive plans pretty soon."
And the analyst offered a question to ponder amid the two campaigns' dueling plans for Medicare. Over the last few years, many HMO's and Medigap programs have raised drug prices, lowered their caps on patients' prescription drug benefits, and stopped serving Medicare patients altogether. Given all that, Moon said the long-term question really is "Will the private sector go the same way as HMO's and Medigap?"