Reports from those who follow congressional wrangling suggest that President Bush’s desire to sign legislation that can plausibly be called a prescription drug benefit within Medicare might be stymied. That would be good news. The differences between popular catch phrases and the actual details of this proposal are quite striking.
What might trip up legislation this time is disagreement over what used to be called means testing but is now called “affluence testing.”
As California Democratic Sen. Dianne Feinstein put it, it means Congress could “ask those who can afford it to pay more for their Medicare premiums.” An amendment she co-sponsored with Sen. Don Nickles, R-Okla., stayed alive on a 59-38 Senate vote before adjournment, although it’s not sure to be in the final Senate version. The House version includes means testing.
But Sen. Ted Kennedy, D-Mass., the key legislator on this issue, has said he will filibuster if the Feinstein-Nickles provision is in the final version. If affluence testing is in a version that emerges from a House-Senate conference committee, Kennedy and other liberals could withdraw support.
The idea of making the cost higher for higher-income seniors is a live issue because a prescription drug benefit will be a new open-ended entitlement whose cost will likely soar. The Congressional Budget Office (CBO) estimates the cost of the proposed program at $400 billion over the next 10 years.
Jeff Lemieux of the Progressive Policy Institute (see www.centrists.org) says that’s just the beginning. The proposal will trigger “a permanent acceleration of spending growth” that by 2030 will take a full 1 percent of Gross Domestic Product. If GDP grows at expected rates, that will mean the drug benefit alone will cost $481 billion per year by 2030.
And some seniors could get less coverage than they have now. About 78 percent of seniors now have some prescription drug coverage, many as part of a retirement package their former employers provide. But if this legislation passes some employers could drop that coverage. The CBO estimates that 37 percent of seniors now covered by employers would lose it, which means they would pay more and get less under the new “benefit.” And there’s the question of adding a new entitlement when the budget is in deficit.
The current proposal is dubious. Let President Bush find another issue to ease his way to re-election.