Drug plan risks senior backlash

In the current negotiations between House and Senate conferees, many key players remember the 1989 debacle.

Still a repeat is possible.

Because of budget constraints, any bill will cover only a portion of the senior drug tab. The Medicare population is expected to spend $1.84 trillion over the next 10 years on prescription drugs, according to the Congressional Budget Office (CBO). Yet, Congress has capped a new drug benefit at $400 billion for the decade.

Another problem is the sheer complexity of the bill. Together, the House and Senate versions stack up to 1,800 pages. Benefits vary from region to region and across income brackets. The House version does not cover individual drug costs between $2,000 and $3,500, while the Senate bill exempts low-income seniors from this "doughnut hole."

"Those currently on the Medicare program like Medicare. What they want is for it to cover their prescription drug costs," says David Certner, director of federal affairs for the AARP, the No. 1 seniors organization. "Whether good or bad, it's going to be a lot more choices and decisions than people had to make before. They are going to be a lot more confused."

One worried senior is Carol Baran, a retiree in Rochester, N.Y. She is caring for a husband diagnosed five years ago with Alzheimer's disease. She wants to make sure they can live together at home as long as possible, but it's forcing some wrenching choices about care, including one drug that costs $400 a month.

"People that have money could pay for that, but there are a lot of us in the middle that fall into the cracks," she says. "If we went under a new government program and later did not qualify, what would there be for people to fall back on? It's scary."

The biggest unknown for many seniors is whether they will lose their own coverage in private plans, provided by their employers or pension plans. The CBO estimates that the passage of either the House or Senate version of the Medicare bill would encourage employers to drop drug coverage for their retirees, affecting 1 in 3 Medicare beneficiaries.

The current House and Senate plans would raise health costs for 3 in 4 Medicare beneficiaries, according a new study released this week by USAction Education Fund, a progressive group.

"The seniors who are likely to be most seriously damaged by the current drug bill are those who have employer-based corporate coverage," says Robert Moffit, director of domestic policy studies at the Heritage Foundation, a conservative think tank. As deputy assistant secretary for legislation at the Department of Health and Human services, he worked with Congress on the 1988 Medicare bill.

"Congress," he says, "ought to be worried about a backlash."

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