Bush Rethinking Medicare Plan

The Cincinnati Post

 February 11, 2003

  WASHINGTON -- A Bush administration plan to require Medicare beneficiaries to join health maintenance organizations as a condition for federally supported prescription drug insurance is being rewritten after complaints from congressional Republicans and advocacy groups for retired people.

"I assure you, the president is not going to force seniors into HMOs in order to get prescription drugs, but the final decision on the prescription drugs has not been made," Health and Human Services Secretary Tommy Thompson told the House Ways and Means Committee.

Thompson said that a prescription drug benefit would be "an entitlement under Medicare" if Congress adopts the Bush proposal. He said the final version of the Bush plan will be announced "relatively soon."

While Thompson ruled out a quid pro quo of prescription drug coverage for HMO enrollment, administration officials made it clear that the president was determined to provide the maximum drug benefit to those who enroll in a managed care plan.

The administration will not back away from its opposition to proposals by Sen. Edward M. Kennedy, D-Mass., and others that would make prescription drug coverage a straight-out benefit of Medicare for all beneficiaries, government officials said.

A key senator, Senate Finance Committee Chairman Charles Grassley, R-Iowa, was one of the first to oppose the Bush plan of mandatory managed care enrollment as a condition of federal support for prescription drug purchases. Grassley said that a mandatory plan would never get through the Senate, which is narrowly controlled by Republicans.

Sen. John Breaux of Louisiana, a pivotal Democrat who has often supported the White House on health care issues, said he would not vote for any plan that requires HMO enrollment.

Congressional Democrats and retiree advocates said that by redrafting its plan, the administration was trying to avoid the accusation that it was coercing senior citizens to sign up with managed care groups.

But the White House appears determined to reach the same goal by enticing seniors into managed care through a prescription drug bonus.

White House officials insisted that the president has not endorsed the mandatory plan that surfaced two weeks ago.