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In the 2000 U.S. presidential race, and in that year's national
congressional campaigns, politicians made a promise to the American
people; if elected, they would find a way to make prescription
drugs more affordable for senior citizens. Both the Gore and
Bush campaigns pledged they would bring this much-needed relief
to seniors. In a political advertisement for Al Gore, a voiceover
noted, "Al Gore is taking on big drug companies to pass
a real prescription drug benefit that covers all seniors."1
Likewise, George W. Bush remarked in a competing television
advertisement at the time, "We will strengthen Social Security
and Medicare for the greatest generation and for generations
to come...We will make prescription drugs available and affordable
for every senior who needs them."2
It has been more than two years since those politicians and
others promised to make prescription drug benefits more affordable
to seniors. Now, nearly one-third of seniors still are without
prescription drug coverage and many more are inadequately covered.
Meanwhile, the price of prescription drugs keeps rising for
Medicare beneficiaries. In 2001, the Congressional Research
Service found that annual per capita spending on prescription
drugs by the Medicare population jumped from $674 in 1996 to
$1,539 in 2000 and is expected to reach $3,751 in 2010.3
Why then hasn't a bill to make drugs less costly for seniors
become law?
House Action
In June 2002, the Republican-controlled U.S. House of Representatives
passed a bill, HR 4954, supporting a prescription drug benefit
for Medicare beneficiaries. HR 4954 would provide $350 billion
over 10 years for such a benefit to be administered through
private insurance companies. Of the total amount, $320 billion
would go toward prescription drugs, while about $30 billion
would go to the private insurance administrators.
Senate Inaction
The U.S. Senate, however, left Washington, D.C. for its August
2002 recess without having passed a comprehensive prescription
drug benefit bill. During the Senate floor debate on the generic
drug bill in late July, the Senate, which has a very narrow
Democratic majority, voted on four separate proposals that addressed
prescription drug coverage for Medicare recipients. None were
passed. This was due primarily to party politics, limited federal
funds, and deep ideological differences. A Democratic version,
a so-called "tripartisan" version, a Republican version,
and a so-called "bipartisan" compromise all were unable
to get the three-fifths majority votes needed to start debate
and were defeated. (If a point of order is raised against an
amendment to a bill, a three-fifths majority, 60 votes, is needed
to pass the amendment.)
On July 23rd, Senators voted down, 52-47, the Democrats' version,
S 2625, which would have authorized $594 billion to fund a prescription
drug benefit (from 2005 to 2012) to cover all Medicare recipients
and to be administered by Medicare. The same day, moderate Republicans,
one independent and one Democrat endorsed a "tripartisan"
bill, which would have spent $370 billion over 10 years on a
fee-for-service benefit administered by private insurance. The
"tripartisan" bill was defeated 48-51.
On July 24th, in an attempt to provide coverage for seniors
most in need, conservative Republicans offered an amendment
with fewer benefits at less cost, calling for $160 billion in
funding over 10 years for their program. This amendment was
also struck down. Finally, on July 31st, one final amendment
was brought to a vote: Democrats and four Republicans tried
to forge a bipartisan compromise. The amendment, offered by
Senators Gordon Smith (R-OR) and Bob Graham (D-FL), which would
have authorized spending $390 billion to provide drug coverage
to Medicare recipients with incomes of less than $17,720 (individual)
or $23,880 (couple) or drug costs higher than $3,300. This final
amendment went down in defeat, 49-50.
Why wasn't the Senate able to pass legislation? On the ideological
level, the parties could not come together because of their
divergent views of how such a program should be funded and administered.
Senate Democrats sought to spend more money on a program administered
by the government, while Senate Republicans, like their House
Republican colleagues, wanted to spend fewer federal funds and
administer the program through private insurers. Politically,
both Democrats and Republicans wanted to be able to claim a
legislative victory for their own party, just in time to use
the success to bring voters to their side for the November congressional
elections.
Though the Senators did not pass a comprehensive drug benefit
program for seniors, they did not leave Washington completely
empty-handed. On July 31st they passed, 78-21, the Greater Access
to Affordable Pharmaceuticals Act, S 812, authored by Senators
Charles Schumer (D-NY) and John McCain (R-AZ), to accelerate
the entry of generic drugs into the market. The Congressional
Budget Office estimated that this bill would save consumers
approximately $60 billion over the next 10 years. The House
of Representatives must act on this before such legislation
could reach President Bush's desk for his signature.
While the generic drug benefit will assist seniors in finding
less expensive ways to finance their drug needs, Medicare beneficiaries
are still without a comprehensive plan to allow them affordable
access to needed medications. With midterm campaigns and elections
coming up, time is running out in this legislative session.
The only way to hold politicians to their promises of a prescription
drug benefit is for seniors and other constituents to demand
that their Senators act on this legislation. Contact them at
their local offices.
What Presbyterians Can Do
What can Presbyterians do to ensure that politicians find a
way to pass legislation to make prescription drugs more affordable
to seniors?
In 1991, the General Assembly passed a resolution, "Christian
Responsibility and a National Medical Plan," which urged
Presbyterians to seek candidates for office who would strongly
support equitable, universal health care. Until that goal is
reached, it urged Presbyterians to call upon candidates to protect
vulnerable people so that their health care benefits are not
eroded.4
As Presbyterians following the recommendations of General Assembly,
we should work to urge our Senators and Representatives to come
together to pass legislation to ensure that seniors have affordable
options to pay for prescription drugs. While your Senators are
on their August recess and are in their home states, call, email,
or write to them to urge them to pass legislation on prescription
drugs to ensure that all seniors in need are protected.
What you can do…
Your U.S. Senators need to hear from you. While Senators are
on their August recess, contact them in their home offices or
in Washington, D.C. to urge them to go beyond party politics
to find a way to support prescription drug coverage for all
seniors in need. Urge them to pass such legislation when they
return from their August recess.
To write to your Senator:
Senator _____________
U.S. Senate
Washington, D.C. 20510
To call your Senator, call the Capitol switchboard at (202)
225-3121 and ask for your Senator and/or Representative.
** When writing or calling your Member of Congress, be sure
to identify yourself. In a letter, include your name and address.
In a phone call, say your name and the city and state in which
you reside. This is important, as it identifies you as a constituent,
and enables the office to follow-up with you by mail or phone.
- Democratic Victory 2000.
"Siding," September 2000, accessed at www.kff.org
- Maverick Media. "No
Changes," August 2000, accessed at www.kff.org
- Congressional Research Service.
Medicare Prescription Drug Coverage for Beneficiaries:
Background and Issue, January 26, 2001.
- Minutes, 1991, p.810.
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