Posted on Tue, Mar. 19, 2002 KRT WIRE Hopes dim among seniors for prescription-drug benefit
BY JACKIE KOSZCZUK Knight Ridder Newspapers

WASHINGTON - (KRT) - When politicians promised during the 2000 election campaign to help senior citizens with the high costs of prescription drugs, 70-year-old Rita Cohn believed them.

Sixteen months later, the Florida retiree and her husband have stopped believing. This spring, they are selling their motor home so they can help pay for more than $4,500 in maintenance prescriptions. That will curtail their cherished road trips to see their four children, seven grandchildren and far-flung friends. But the Cohns feel they have no choice.

Millions of senior citizens face similar decisions as hopes dim for a government-paid prescription-drug benefit this year. Though all sides in Washington endorse the idea of subsidizing the costs of prescription drugs and Congress will discuss various proposals in coming weeks, it's highly unlikely that any of them will be enacted, according to people on the front lines of health care-policy struggles.

There is simply not enough time, money or political will to do it this year, they say. The projected tax surpluses that had been expected to pay for prescription drug coverage are vanishing, thanks to the war on terrorism, last year's recession and President Bush's tax cuts. And Democrats need an issue to run on in November's congressional elections more than they want to compromise with Bush and Republican lawmakers on a question that exposes deep philosophical differences among them.

"It will be very difficult to make progress on prescription drugs this year," said Ron Pollack, executive director of FamiliesUSA, a liberal consumer group that is pushing for legislation. "There will be a lot of rhetoric on this issue, but unfortunately too little action."

Republicans in the House of Representatives are at odds with their own president over what to do. Their fiscal 2002 budget would set aside $350 billion for prescription-drug subsidies over 10 years. President Bush proposes to spend just $190 billion over 10 years. Senate Democrats have not yet released their proposal, but it is expected to cost much more than either Republican plan, at least $500 billion over a decade.

Agreeing on a number is just the first step. After that, lawmakers from both parties must resolve major differences over how to make the program work.

Republicans want to pair the new benefit with an overhaul of Medicare itself, to make the program more competitive and to allow the private sector a greater role.

Most Democrats oppose that approach, preferring to leave the popular program in federal hands.

Also, Republicans generally favor targeting any prescription-drug benefit to low-income elderly couples, those with income of roughly $17,000 a year or less. Democrats say the benefit should be available to anyone who is enrolled in Medicare, the federal health-care entitlement program for people 65 and older.

"There are big philosophical differences without a clear path to what the in-between position is," said Dan Danner, who heads the Health Benefits Coalition, a business lobby.

Time is short to solve all those problems before November's congressional elections, at least from a politician's standpoint. Many primary contests, the first phase, are just weeks away, and the partisan fight for control of Congress this year is intense.

Democrats hold only a one-seat advantage in the Senate, and they can gain control of the House by adding only six seats there.

But Republicans are led by a president with high approval ratings who is waging a popular war on terrorism. Domestic issues, in which Democrats often have an advantage with voters, are taking a back seat, at least for now.

In that political context, many Democrats think that campaigning for a new prescription drug benefit is one of the few issues that can make a big difference for their candidates in November.

"This is a very potent issue," said Jim Jordan, executive director of the Senate Democrats' re-election committee. "It will be in play in virtually every state. Prescription drugs are a crushing burden on middle-class families, and voters are looking for some relief from the government."

Rep. Bill Thomas, R-Calif., the influential chairman of the House Ways and Means Committee, said the House probably will pass a prescription drug bill this year, but he acknowledged that compromise with the Senate on the issue is probably impossible.

"Can it be done and will it be done are two very different questions," Thomas said.

"The issue is very political. And even if we do a good bipartisan bill (Democrats) may vote against it."

That doesn't mean the issue is dead forever, but it does mean that seniors will have to wait longer for relief.

"Both sides are positioning themselves more for the 2002 election, with the notion that this will actually be fought out after that," said Gene Sperling, former economic-policy adviser to President Bill Clinton.

Of the approximately 40 million senior citizens in the Medicare program, only half have private-insurance drug coverage, despite high demand among the elderly for medicine.

Private plans that cover prescription drugs are either unaffordable or unavailable for many seniors.

The experience of Rita and Dan Cohn, of Fort Lauderdale, is typical. They rely on a variety of medicines to help maintain their cholesterol levels and to keep Rita's diabetes in check. In 2000, their health maintenance organization dropped their doctor, so they switched insurance plans to be able to keep going to the same physician. Their new plan covers only $2,000 in drug costs a year, and their medicines run about $4,700.

They were happy when prescription drugs became a major issue in the Bush-Gore presidential campaign. "We had hoped that a drug bill - even one amended or changed from what was promised - might give us a little help," Rita Cohn said.

"But nothing's happened. We understand that the country is preoccupied," she said. "Most of us are middle income, and we're falling through the cracks."


2002, Knight Ridder/Tribune Information Services.