GOP delays drug vote to try to expand support

WASHINGTON -- The Republican Party's signature plan to create a Medicare drug benefit for seniors might be in jeopardy because some House GOP members do not want to vote for it.

It is unusual for rank-and-file House Republicans to defy their leaders, especially on something the party has made a major issue in the upcoming November election. The plan is such an integral part of the GOP campaign that some Republican candidates are using the proposal in their speeches and campaign ads.

The GOP bill, which was unveiled with great fanfare last week, was scheduled to come to the House floor for a vote Wednesday. The vote was delayed, however, because the GOP did not have the necessary 218 votes.

Instead, Republican leaders held a closed-door caucus to do some last-minute arm-twisting.

"People need to be better educated," said Rep. Nancy Johnson, R-Conn., chairman of the House Ways and Means health subcommittee.

After the caucus, it was not clear whether the leadership intended to call the bill up for a vote today or wait until after the Independence Day recess. Originally, the Republican leadership pledged to pass it before Memorial Day. That deadline came and went because of opposition from doctors and hospitals seeking higher Medicare reimbursements, which are now in the bill.

President Bush has not expressed support for the bill, although he supports the idea of a Medicare drug benefit.

Written mostly by Chairmen Bill Thomas, R-Calif., of the Ways and Means Committee and Billy Tauzin, R-La., of the Energy and Commerce Committee, the GOP bill would invest $350-billion in Medicare drug benefits over the next 10 years. It is much less generous than several Democratic proposals, which would cost more than $500-billion.

Doctors, hospitals and drug companies support the bill, primarily because they would benefit directly. Opponents include the nation's pharmacy owners and some senior citizen groups, which prefer the Democratic alternatives.

Craig Fuller, executive director of the National Association of Chain Drug Stores, told House Speaker Dennis Hastert in a letter Tuesday that the pharmacy operators oppose the measure because it would drastically reduce their role in dispensing prescriptions to seniors.

The House GOP proposal "turns over the pharmacy care needs of seniors to unregulated and unlicensed prescription benefit managers that will operate under an untested and dangerous risk-based program for seniors, which will not succeed in the real world," Fuller wrote.

A number of Republicans including Rep. Donald A. Manzullo of Illinois, who heads the House Small Business Committee, are known to be sympathetic to the views of the NACDS and other drugstore trade groups. They see it as a matter of supporting small business.

Other Republicans are wary of the GOP bill for other reasons:

Reps. Jo Ann Emerson of Missouri, Gil Gutknecht of Minnesota and Jack Kingston of Georgia think it needs to do more to directly control rising drug prices.

Staunch conservatives such as Mac Collins of Georgia question whether Congress should be creating an expensive new entitlement program when many seniors seem perfectly happy with their privately funded drug benefit.

Some members are trying to extract costly concessions from the leadership to help their constituents. For example, Rep. Marge Roukema of New Jersey wants providers in her area to be reimbursed by Medicare at the same, higher rates as providers in nearby New York City.

Several experienced congressional head-counters said the Republicans were at least 12 votes short of a majority Wednesday. Although they were certain to lose some of their members, Republican leaders said they had succeeded in recruiting a few Democratic votes from conservatives such as Rep. Ralph Hall of Texas. Hall said he would support the Republican plan if the Democrats' bill is defeated.

Chris Hansen, AARP's director of advocacy, said that while his organization favors a more generous bill proposed in the Senate by Florida Democratic Sen. Bob Graham, the AARP is encouraged that Republicans are trying to "move a bill forward."

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