Diagnosis Time on the Hill

By Shailagh Murray and Charles Babington
Tuesday, January 31, 2006

Is the Medicare drug benefit suffering from start-up pains, or is there something more serious going on?

Lawmakers got an earful from seniors about the new program while they were home for the winter recess. Now that Congress is back in session, lawmakers will begin weighing whether to make legislative adjustments or wait and see whether the glitches work themselves out.

On Thursday, Medicare officials will testify before the Senate committee on aging about how the various problems are being addressed. Big concerns include a coverage breakdown affecting low-income seniors who are eligible for both Medicare and Medicaid, forcing many states to intervene to pay for their prescriptions, and the dizzying array of insurance plans that many beneficiaries must sift through to find the one that best suits their needs.

Next Wednesday, the Senate Finance Committee will take up the matter, a follow-up to a meeting held last week between panel members and Medicare officials, including Health and Human Services Secretary Mike Leavitt. After that session, Finance Chairman Charles E. Grassley (R-Iowa) said he wanted to preserve the current approach to covering "dual-eligible" beneficiaries. He said he agreed with Leavitt's assessment that no legislation was needed at this time.

"We should focus on administrative remedies because they will be faster than legislation," Grassley said, while acknowledging that "yes, there have been problems, and, yes, they need to be fixed and fixed fast."

As Democrats see it, the greater the sense of crisis, the more likely the backlash by elderly voters in the November midterm election. Although the benefit took effect just a month ago, on Jan. 1, Democrats are pressing Republicans to streamline the benefit, to make it easier for seniors to navigate, and to provide emergency relief for people who are having trouble getting their prescriptions filled.

Rep. Henry A. Waxman (Calif.), a senior House Democrat, vented about the plan in the party's Saturday radio address. "Instead of using Medicare, which seniors and persons with disabilities have relied on for years," he said, "the program was turned over to hundreds of private insurers who can charge what they want, cover what drugs they want and change what they cover at will."

Scuttle the Pre-Buttal

In the quaint old days, Congress's opposition party waited for the president to finish his annual State of the Union address before criticizing it. But the preemptive potshots that began several years ago have morphed into a week-long extravaganza that consumes far more time and words than President Bush will use tonight.

Last Thursday, two top Democrats -- House Minority Leader Nancy Pelosi (Calif.) and Senate Minority Whip Richard J. Durbin (Ill.) -- delivered a heavily promoted "Democratic pre-buttal to the President's State of the Union Address" at the National Press Club. The next day, Senate Minority Leader Harry M. Reid (D-Nev.) told the U.S. Conference of Mayors: "Let us hope President Bush uses the State of the Union to offer a real policy that helps our mayors protect America."

That was just a warm-up for Reid. Yesterday he spent 25 minutes on the Senate floor critiquing Bush's policies, point by point. The Senate ostensibly was debating a Supreme Court nomination, but Reid roamed far afield. "It's not credible for the president to suggest that the state of the union is as strong as it should be," he said. "From health care to national security, this Republican corruption here in Washington has taken its toll on our country."

For good measure, Reid's office then issued a 13,800-word report "on the credibility test the president faces" tonight. And in a separate release, Reid offered a report on "The State of Our Union for Hispanics Under George W. Bush," and another for African Americans.

And if that is not enough, yet more pre-speech activity is scheduled: Reid and Pelosi will hold a "pen and pad" briefing for reporters this afternoon.

It was all too much for Senate Majority Leader Bill Frist (R-Tenn.) who issued a statement chastising Reid, by saying, "Real leadership involves putting forward ideas and solutions not just criticizing."

Another Congressional Leak

If you plan to exit the Capitol anytime soon, heading east from the Rotunda, watch that first step. Workers are removing the granite "east front central steps" because water has been seeping through them into the underground Capitol Visitor Center, still under construction.

Workers will replace the "waterproofing membrane" beneath the steps and then rebuild them, according to the Capitol superintendent's office. Wooden steps will permit emergency exits in the meantime.

The leak discovery is the latest in a long line of problems that have pushed the visitor center's estimated cost from $265 million in 1999 to about $550 million today.

© 2006 The Washington Post Company