GOP Works On Elderly Rx Remedy

Medicare recipients would receive protection against catastrophic drug costs and the low-income elderly would get federal subsidies for all their prescription expenses under election-year legislation that Republicans intend to bring to the House floor by Memorial Day.

GOP officials, speaking on condition of anonymity, said Tuesday the legislation also will incorporate President Bush's proposal for government-issued prescription drug discount cards designed to reduce the cost of medicine for Medicare beneficiaries.

These officials said final details remain to be worked out on the bill, which envisions older Americans receiving coverage from private insurance companies in a market overseen by Medicare. The program, which officials stressed would be voluntary, is expected to cost the government $350 billion over 10 years.

With House action several weeks away, GOP officials said Speaker Dennis Hastert, R-Ill., would commit his rank and file to a set of principles on Medicare and prescription drug coverage on Wednesday. The issues traditionally favor Democrats and are expected to play a major role in this fall's midterm elections, with control of the House at stake.

According to material prepared for release, Hastert was expected to stress a need to lower the cost of prescription drugs immediately and guarantee prescription drug coverage for all older people, as well as a stronger Medicare overall, with more choices and more savings.

"A fair and responsible plan must strengthen Medicare by ensuring the program can deliver necessary health care services, including the addition of an affordable and voluntary drug benefit under Medicare," it said.

Even before Republicans have released their legislation, Democrats were attacking it. "Unfortunately, for that amount of money you can't cover the people who need to be covered," said House Democratic Leader Dick Gephardt, D-Mo. He called it the same "warmed-over stuff we've seen before."

Many Democrats generally favor a uniform prescription drug benefit to be administered through Medicare.

The $350 billion that House Republicans have set aside over the next decade for prescription drug coverage contrasts with the $190 billion that Mr. Bush proposed and is well in excess of the $160 billion earmarked for a prescription drug bill that the GOP pushed through the House two years ago. The result is a more robust federal benefit than Republicans endorsed in 2000.

Several sources said the outlines of the legislation were discussed Tuesday at a private meeting of House leaders. They stressed that the final details remain to be worked out, and costs could vary.

For all but low income Americans, officials said seniors would pay monthly premiums, likely in the range of $37 a month. Additionally, they would pay deductible amounts, possibly the first $250 of drug costs annually. After that, the federal government would pick up approximately 75 percent or 80 percent of the costs of drugs up to $1,000, and perhaps 50 percent of the next $1,000 in costs.

Over $2,000, individuals could be required to pay out of pocket the full costs of additional drugs, up to an amount to be determined, probably $5,000. After that, insurance would pay.

Older people with incomes up to 135 percent of the poverty level would have all costs paid, with partial subsidies for seniors with incomes of up to 150 percent.

Republicans have long conceded a political problem with the issue. Private and public polling alike shows Democrats are favored on the issue by double-digit margins over the GOP.

GOP candidates, attacked ferociously two years ago on the prescription drug issue, countered that the House had passed legislation to address the problem. The measure died in the GOP-controlled Senate, but party strategists concluded that response helped Republicans hold control of the House.

Democrats have made it clear they intend similar attacks this year, and Republicans long ago decided they would have a similar response. Expressions of support for prescription drug coverage in television commercials have "a positive impact on party and candidate confidence on this issue and health care in general," strategists told rank and file Republicans in a presentation last week.