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Means Test Sought for Medicare Drug Plan
The Senate rejected a similar proposal from Sen. John Ensign (R) in March.
(By Mark Wilson -- Getty Images)
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"I will be looking constantly for ways to put this before the Senate," he vowed yesterday.
The proposal will have the support of some budget hawks from both parties, who say a response to the looming crisis in entitlements must come before the heart of the baby boom begins drawing Medicare and Social Security benefits.
"Means testing is going to be a necessary part of all our entitlement programs," said Rep. Jim Cooper (D-Tenn.), who is seeking a new commission to tackle the issue. "We simply cannot afford the promises we've made."
Ron Pollack of the liberal advocacy group Families USA said an income-based surcharge could make sense, as long as the thresholds rise with inflation, the government does more to help the poor obtain coverage, and no one is excluded from the program.
"As long as this doesn't have an exodus of the wealthy from the program, we think having premiums established based on ability to pay makes sense," Pollack said.
Nothing is particularly wrong with the suggestion that more affluent seniors should pay more, said Scott Lilly, a budget analyst at the liberal Center for American Progress.
But politically, he added, the deal hinges on a betrayal of the coalition that Republicans painstakingly assembled to pass the prescription drug law in 2003. AARP's endorsement was particularly pivotal in securing its narrow passage, and it may never have happened had means testing been included, Lilly said.
"Most people would think, 'If I compromise with you, this is something we'll go forward with into the indefinite future, and you're not going to pull the rug out from under me four years down the road,' " Lilly said. "That's what's more breathtaking about this than the rightness or wrongness of the policy."
Advocates for seniors say the Bush proposal is flawed for reasons both administrative and philosophical. Unlike the physician program, a uniform benefit for which seniors pay premiums directly to the government, Medicare's drug coverage is operated through private insurance companies, with seniors selecting from among many different plans.
Advocates question how a new surcharge would work in such a sprawling, diverse system.
Staff writer Christopher Lee contributed to this report.
