By Patricia Barry
September 2002

	Older Americans Angry over Senate Deadlock on Drugs Plan-by-Plan List of Pharmacy Assistance Programs

A bitter battle in late July ended in the Senate's failure to pass any legislation for prescription drug coverage in Medicare, with the political parties still deadlocked ideologically on how much a benefit should cost and how it should be run.

The news dismayed older Americans struggling to afford the drugs they need to stay healthy. They say they are losing patience with lawmakers who promise action, fail to agree on how to act, then accuse each other of being the bad guys.

"People are angry. They see politics at work instead of government at work," says AARP's Director of Advocacy Chris Hansen. So in the run-up to the November elections, he warns, "candidates who think they can use the deadlock to their advantage by pointing the finger at someone else are taking a huge risk."

	Call the Senate "AARP members need to keep the pressure on so the Senate can finish the job," says AARP Director of Advocacy Chris Hansen. Call your senators at (800) 869-3150 and say: "Senators need to make good on their promise to pass, this year, a comprehensive Medicare drug benefit that provides real value." Or go to www.aarp.org/prescriptiondrugs, and click on "Contact Congress."

Expecting the issue to play big in November—because older voters turn out in strength in mid-term elections—senators might still reach compromise in the fall to produce a drug benefit this year, analysts say, though it will be an uphill struggle.

As lawmakers left Washington for the August recess, AARP vowed to keep up pressure for a compromise. Hoping to break the gridlock, it is suggesting new ideas for a "middle way" Medicare benefit that both sides may be able to live with.

Meanwhile, there was at least one sign of progress. Though the Senate failed to pass competing Democrat and Republican bills for a drug benefit, it did pass three other bills designed to make drugs more affordable for everyone. They passed by a large majority—handing a major defeat to drug industry lobbyists and signaling a changed attitude among lawmakers to the need to rein in drug prices.

Struggles in the Senate
Because the House had already passed a Republican bill, Senate Democrats felt they had to pass a bill that candidates could take to voters in November.

But the Senate Democrats' bill (estimated to cost $594 billion over 10 years), while gaining a majority of 52 to 47 votes, failed to meet the 60 it needed to pass under Senate rules. A $370 billion Republican bill—known as the Tripartisan bill because it also has two Democrats and one Independent as cosponsors—also failed, voted down by 51 to 48.

With only days to go before the August recess, the Senate Democrats then introduced a $400 billion scaled-down "fallback" bill that would have given coverage only to beneficiaries with either low incomes or high drug expenses. That failed, too, and efforts to win more Democrats over to the Tripartisan bill, by adding $30 billion to sweeten its benefit package, also collapsed.

These defeats reflect the ideological divisions that have long frustrated attempts to pass a Medicare drug benefit. One hurdle is the price tag: Democratic proposals cost more than Republican versions, which some lawmakers also see as too expensive. Another is the delivery system: Democrats prefer a benefit run by Medicare while Republicans favor competing private health plans.

Speaking to the AARP Bulletin soon after the Tripartisan bill failed, its Republican cosponsor, Chuck Grassley of Iowa, said that in the interests of compromise he would be "willing to spend more money." But, he added, "I think the philosophy behind the delivery system of the Tripartisan plan is so good that it would be very difficult for me to compromise on that."

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Democrat Debbie Stabenow of Michigan, chair of the Senate Prescription Drug Task Force, also saw little chance for compromise. "The Tripartisan bill is a move toward privatizing Medicare, and it has almost no support within the Democratic caucus," she said. "We are committed to Medicare. We do not want to see it move to a private HMO system."

AARP supported the Senate Democrats' benefit proposal. AARP members, polled in focus groups, generally preferred the Democrats' more generous benefit package, wanted drug coverage to stay within the government-run Medicare program and questioned the stability of the private insurance plans on which Republican proposals rely.

But, faced with a polarized stalemate over delivery systems, AARP has begun to explore other ideas for finding common ground. One suggestion embraces both parties' philosophies: competing private plans backed up by a government system to guarantee drug coverage.