Perspective               

Medicare Prescription Drug Bill Stalled in Congress

Over the summer, prescription drug coverage for older and disabled Americans had the support of both Democrats and Republicans. But today, plans for a prescription drug bill stand stalled in Congress as a result of over-ambitious aims, clashing priorities, slackening political will, and lobbying by an array of interest groups. Neither the House nor the Senate bill could win support now in the other chamber, and some legislators are concluding that no bill would be better than one that does not provide enough benefits.

One issue now delaying a decision is the fact that older adults themselves have had lukewarm reactions to both bills. Additionally, lawmakers stand divided on how much power the private sector should have. Many believe that by encouraging private plans to compete with Medicare, younger and healthier seniors would be drawn to private plans, leaving the government plan with individuals with costlier health care needs and higher premium costs. Other legislators fear that if the government offers a prescription drug benefit, employers will drop prescription drug coverage, potentially leaving some individuals—and particularly union retirees—with worse benefits.

Regardless of the causes, the passage of a prescription drug benefit is not looking good. Now, in order to provide at least some help to those who need it, some lawmakers are considering a smaller bill that would exclusively serve low-income Americans and those with catastrophic prescription drug costs. Conservatives have proposed as an alternative a bill involving means-testing, or, in other words, a bill that would serve everyone but that would require higher-income individuals with Medicare to pay more for coverage. Finally, some politicians favor scrapping any bill completely in favor of a provision to allow Americans to buy lower-cost drugs in Canada.

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