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December 07, 2003

Will the Medicare Bill Kill the GOP?

For those of us who see danger for the GOP is passage of the Medicare prescription drug bill, an oft times cited example is the 1988 "long term health care" bill-- which led to near riots against the Dem leaders who passed it, largely because of the increased premiums for some seniors.

Some GOP leaders have argued they escape that danger because the new plan is voluntary:

Senate Republicans counter that, unlike the 1988 plan, the new Medicare reform is voluntary.

If seniors don't like the plan, they don't have to sign up. So how can they object to a plan that they only use if it benefits them?

Well, there's a big kicker-- while they don't have to sign up for the Medicare prescription drug bill, as of 2006, seniors will have to drop any private "Medigap" plans that cover prescription drugs. Whether many of those plans would offer a better deal than the subsidized Medicare plan is unclear, but the point is that seniors' choice will now be limited to either carrying the full cost of prescription drugs or using the bizarro new system.

This makes the mantra that the plan is "voluntary" a bit of a crock. Which will piss off seniors even more, if only because they were lied to by the GOP and AARP on this point.

Helps Poor Seniors? Hey, but at least poor seniors will get more drug coverage. For the near-poor seniors, who didn't qualify for Medicaid, that's mostly true. For Medicaid recipients who will be forced to switch over to the new system, coverage will likely be worse:

Under the bill, low-income elderly people eligible for both Medicare and Medicaid, the federal-state program for low-income people, would receive their drugs through Medicare. Medicare drug plans will almost certainly cover fewer drugs than Medicaid now covers, state officials say.

And state governments will generally be banned from giving additional prescription drug benefits to seniors beyond the Medicare bill, although a few states already offering such benefits like New York State will have the programs continue in modified form in the new system.

So even choice by states on how to supplement benefits for their seniors has been limited in the bill.

While the bill may in aggregate be an improvement on the status quo, seniors are going to be in serious revolt over the bill's many downsides. With Democrats promoting new legislation to fix these problems and the GOP resisting, I would still bet on the prescription drug issue to be a strong plus for the Democrats next year.

Posted by Nathan at December 7, 2003 04:04 PM

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