Congress May Balk at Bush’s Two-Step Prescription Drug Benefit
To "dramatize his commitment" to addressing the high cost of prescription drugs, President-elect Bush and his advisers are considering pushing an "early spending bill" that would provide block grants for states to "funnel subsidies" for drugs to "needy" Medicare patients. The Wall Street Journal reports that Bush is "eager" to go forward with his "immediate helping hand" plan as a way to address the proposals he made during the campaign and to show "strength amid a divided government." During the campaign, Bush proposed granting the states $12 billion a year as a "first step" while Congress and the administration worked to develop a "comprehensive overhaul of Medicare" that would provide drug benefits by fostering "private insurance options" (Calmes, Wall Street Journal, 1/12). But Sen. Charles Grassley (R-Iowa), soon to become chair of the Senate Finance Committee, said there is "little congressional interest" in the block grant program and expects it to be "dead before its arrival." Grassley supported the program during the campaign, but said other senators view the idea as a "cop-out" to avoid enacting permanent Medicare reform. He said the proposal has "little support" among Democrats and lacks full support among Republicans (Norman, Des Moines Register, 1/11). Rep. Bill Thomas (R-Calif.), who will chair the Ways and Means Committee, also "dislike[s]" the block grant approach (Wall Street Journal, 1/12). Grassley said that it "must be made clear" to Bush that "another approach is needed" on the issue. Bush spokesperson Scott McClellan said Bush "intends to carry through on his two-step plan" (Des Moines Register, 1/11).
If the cost of co-payments is too high, having a drug benefit in Medicare "will be of little use," a study by Harvard Medical School researchers found. Published in the journal Health Affairs, the study found that as out-of-pocket costs increased, the number of seniors taking medication decreased. Alyce Adams, an assistant professor at Harvard Medical School, said, "The key (thing to) take away here is that it's not enough to give people coverage. You have to think about whether the co-pays are prohibitive, particularly for people in the lower income groups. ... It's really important to be careful when developing a drug coverage benefit to think about the consequences" (Powell, Boston Herald, 1/12).