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New Offensive on Medicare Drug Benefit

By Shailagh Murray and Charles Babington
Tuesday, February 28, 2006

Democrats are stepping up their attacks on the Medicare drug benefit, which they regard as an increasingly ripe issue for the November midterm elections.

Senate Democrats held their own independent hearing yesterday, with testimony from five health policy experts. Broad areas of concern included confusion over the many plans offered and enrollment problems that low-income seniors have encountered. Sen. Byron L. Dorgan (D-N.D.), who presided over the session, invited a Fargo pharmacist to describe day-to-day problems, including how some pharmacists must take out bank loans to cover reimbursement delays. "This is simply unacceptable," Dorgan said.

Today, House and Senate Democrats will outline concerns raised by seniors at the nearly 100 Medicare town hall meetings that Democratic lawmakers held over the Presidents' Day recess. House Minority Leader Nancy Pelosi (Calif.) said her party advocates "a complete overhaul of this disastrous prescription drug plan."

Seniors are a crucial voting bloc, and Republicans hope they will bear in mind that, despite the problems, the GOP at least delivered coverage. Senate Finance Committee Chairman Charles E. Grassley (R-Iowa) noted yesterday that when Congress and the White House were under Democratic leadership, seniors had "nothing, zero, zilch."

That said, Republicans have acknowledged glitches and are holding hearings and town hall meetings to help educate seniors about the benefit. The Bush administration has taken a first step toward simplifying the program by circulating a memo last week among benefit providers that seeks ideas for possible changes to the plan.

Democrats are trying to link the Medicare benefit to last year's effort by Bush and Republican lawmakers to partially privatize Social Security, to make a case that the GOP is tampering with sacred retirement programs. The Democrats' slogan: "Let Medicare be Medicare."

They are rallying around three proposed changes to the benefit. They want to delay for six months the May 15 deadline for seniors to enroll in the program to avoid a monthly fee, which Democrats call "the Medicare complexity tax." They say beneficiaries need more time to sort through the dozens of plans being offered in many communities. Many Democrats also want to give Medicare the authority to directly negotiate drug prices and to reimport drugs from abroad, to provide more competitive pricing. And they want to eliminate program subsidies that the program pays, particularly to managed-care plans.

"Nobody said this was going to be easy," said Rep. Rahm Emanuel (Ill.), chairman of the House Democrats' campaign committee.

Republicans Search for NSA Compromise

At 5 p.m. today, several Senate Republicans will huddle with Majority Leader Bill Frist (Tenn.) in hopes of loosening one of Congress's toughest knots: how to provide oversight of the Bush administration's domestic surveillance operations without impairing the ability to spy on possible terrorists.

Frist wants to keep his caucus from fracturing over the issue now that Judiciary Committee Chairman Arlen Specter (Pa.) is proposing a bill that many fellow Republicans oppose. The White House, meanwhile, has signaled that it wants as little congressional meddling as possible.

President Bush secretly began the National Security Agency program in 2001 to monitor possible terrorists, contending it was not subject to the 1978 Foreign Intelligence Surveillance Act. The act established a secret court to rule on domestic wiretap warrant requests.

Specter is circulating language that would require the FISA judges to rule on the NSA program's constitutionality. Should it pass that test, it would operate under FISA guidelines. Specter's committee will hold a hearing on the program's constitutionality today.

Sen. Mike DeWine (R-Ohio) is pushing a rival plan that would keep the NSA program separate from FISA and provide a mechanism for oversight by a bipartisan band of House and Senate members.

Some Republicans consider Specter's plan too restrictive and DeWine's too lenient. Frist's gathering of Republicans from the judiciary and intelligence committees today will seek a possible compromise, several sources said.

One idea, Sen. Lindsey O. Graham (R-S.C.) said yesterday, "would include statutory blessing of the current surveillance program, a limited but meaningful role for the FISA court and a warrant requirement" if there is reason to believe "an American citizen is collaborating with the enemy." The plan, which some call "DeWine plus," would not allow the FISA court to rule the NSA program unconstitutional, said Graham, a Judiciary Committee member.

Intelligence committee member Olympia J. Snowe (R-Maine) hopes "there will be a way that aspects of Senator Specter's and Senator DeWine's legislation can be married," her spokeswoman, Antonia Ferrier, said.

Even if the Senate finds a middle path, it is unclear the House would follow. Intelligence committee Chairman Peter Hoekstra (R-Mich.) "has been pretty strong that the program does not need to fall under FISA, that the authority lies elsewhere," said his spokesman, Jamal Ware.

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