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Party of limited government stands to reap windfall if Medicare bill passes

Drug bill big gamble for GOP

Posted: Tuesday, October 28, 2003

WASHINGTON Memo from Republican pollsters to the GOP-controlled government: Approve Medicare prescription drug legislation, the sooner the better. A political windfall may await.

It's a conclusion reached in survey after survey, delivered to lawmakers and their staff in meeting after meeting. And it's partly responsible for the drive to write a bill that can pass Congress and be signed into law by President Bush by year's end.

''When you're looking at the fact that the Republicans control the government, the Medicare issue becomes a governance issue,'' said Linda DiVall, one of several Republican pollsters to look into the issue. In addition, she said in an interview, passage of legislation gives the GOP the chance to ''provide a benefit that people would be pleasantly surprised came from Republicans.''

Added pollster William McInturff: ''I have been saying for a long time that it is an enormous positive for the president to have passed a Medicare prescription drug benefit.'' McInturff wrote recently that the legislation would make 2004 ''better and stronger'' for President Bush and congressional Republicans.

For their part, some Democrats argue that Republicans face trouble if they go ahead with plans to pass legislation combining a drug benefit with measures to overhaul the entire Medicare program.

''If they pass something that's bad, then they're going to pay a very high price,'' said Celinda Lake, a Democratic pollster. ''This bill is so bad, it reminds me of the catastrophic experience,'' she added. It was a reference to legislation that a Democratic-controlled Congress passed in the late-1980s providing catastrophic medical benefits, but requiring wealthier older Americans to pay a surcharge for them and was forced to repeal swiftly.

Republicans are no doubt aware of the political pitfalls, having been attacked in past campaigns for favoring a privatized Medicare system, and having been warned anew.

"Seniors' satisfaction with their coverage means they are not looking for fundamental change in the Medicare program, whereas a clear majority of the general electorate and pre-seniors are looking for fundamental change,'' DiVall wrote, based on a survey completed in early September for the Federation of American Hospitals.

There is irony in what the Republicans are attempting. And there is accompanying controversy reflected in the effort at a compromise that can pass the House, dominated by conservatives, and the Senate, where modest bipartisanship, at least, is a prerequisite to approval.

Republicans, a party of limited government whose lawmakers voted overwhelmingly against the original Medicare program in 1965, are on the verge of passing the largest expansion of the program since its creation. Conservatives grumble about that, and those who grumble the loudest accounted for most of the 19 Republican votes in opposition to a measure that passed the House in the summer.

Some conservatives who voted in favor of that bill did so in spite of the new benefit, not because of it.

Several weeks later, they wrote House Speaker Dennis Hastert, R-Ill., that they had supported it because ''in addition to creating a prescription drug benefit, it provides limited but necessary free-market reforms to ensure the long-term solvency of Medicare.''

They told him any congressional compromise measure must preserve that approach or they ''cannot in good conscience'' vote for it.

In the same letter, they suggested an alternative: a ''limited prescription drug benefit serving only Americans who truly need it'' meaning low-income older people and those with extremely high drug costs.

To some measure, the divide in Congress on that issue is mirrored among the party's pollsters.

''The key thing is a universal benefit'' that goes beyond a government-backed discount card that entitles older Americans to discounts on their prescriptions, said DiVall, president of American Viewpoint.

But research by David Winston, who polls for House as well as Senate Republican leadership groups, has found favor for an approach that gives all older Americans a discount card while reserving direct government subsidies for those most in need.

Bush himself settled that argument long ago. Lobbying for votes last summer, he told dissident Republicans he had campaigned in 2000 for a benefit to be available to all older Americans, and added, ''We're here to deliver.''

If Medicare legislation was a campaign promise three years ago, it may be more than that now. Bush's poll ratings are eroding in general in the wake of postwar difficulties in Iraq, including among older people.

A New York Times-CBS poll taken this month showed Bush with 41 percent support among voters age 65 and older, down from 44 percent in July and 63 percent in May.

David Espo is chief congressional correspondent for The Associated Press.



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