Health care plan trips, but keeps moving

Pharmaceutical companies may narrow Medicare coverage gap

? Democrats got a sobering glimpse of what it would look like if their ambitious health care overhaul ran into a wall — and they quickly pulled back to regroup and get moving again.

Trying to regain the initiative, House Democrats on Friday unveiled draft legislation they said would cover virtually all of the nation’s nearly 50 million uninsured as President Barack Obama has promised. However, they offered few details on how to pay for it.

The president welcomed their action as “a major step toward our goal of fixing what is broken about health care while building on what works.”

But in the Senate, two committees were getting bogged down, struggling to cope with a trillion-dollar-plus price tag over 10 years. Their House colleagues simply steered away from costs and focused on the promised benefits of the legislation.

Republicans weren’t cutting them any slack and sharpened their criticism. “I fear this plan will force tens of millions of Americans to lose their current health care coverage,” said Rep. David Camp, R-Mich., one of the top GOP lawmakers on health.

The Obama White House played down the turmoil as nothing more than inside-Washington drama.

“We continue to put one foot in front of the other in the march toward health care reform,” declared press secretary Robert Gibbs.

Major provisions of the 850-page House bill would impose new responsibilities on both individuals and employers to get coverage, end insurance company practices that deny coverage to the sick and create a new government-sponsored plan to compete with private companies.

The insurance industry said it has fundamental problems with the proposal for a government plan but stopped short of declaring outright opposition to the overhaul.

House Democrats say they won’t reveal how they intend to pay for their plan until later. Higher taxes on upper-income households appear likely, but broad levies — even a federal sales tax — are also under discussion.

Democrats are aiming to raise about $600 billion in new taxes over 10 years to help pay for the House bill. They would get the rest from spending cuts. Payments to drug companies are on the chopping block.

Rep. Henry Waxman of California, chairman of the Energy and Commerce Committee, said drug makers reaped a “windfall of billions of dollars” from the Medicare prescription benefit and Congress wants some of it back. At issue are seniors who had been covered under Medicaid — which requires rebates from drug makers. Their prescriptions were switched to Medicare, which doesn’t.

Ken Johnson, a senior vice president for the industry group Pharmaceutical Research and Manufacturers of America, disputed Waxman’s assessment. The Medicare drug benefit “pure and simple is not a windfall,” he said.

Narrowing the gap

Behind the scenes, drug makers are negotiating with the White House to find savings of $75 billion over 10 years.

The White House, key lawmakers and the pharmaceutical industry are negotiating a possible deal to have drug companies pay for narrowing a gap in coverage in the prescription drug program for Medicare, officials said Friday night.

These officials said the proposal under discussion would have drug firms pay part of the cost of brand name drugs for lower and middle-income seniors in the so-called “doughnut hole,” a term referring to a feature of the current drug program that requires beneficiaries to pay the entire cost of prescriptions after initial coverage is exhausted but before catastrophic coverage begins.

Additionally, officials said any agreement might include a reduction in anticipated payments for the pharmaceutical industry under government-run health programs such as Medicaid. The officials spoke on condition of anonymity to discuss private negotiations.

The House leaders’ news conference on health care legislation capped a week in which the health care overhaul effort seemed to stumble at the starting line.

A $1.6-trillion, ten-year cost estimate forced the Senate Finance Committee to delay introduction of its bill as members sought ways to scale it back. The Senate Health, Education, Labor and Pensions Committee made little progress as it considered amendments to an incomplete bill.

The whole enterprise is “basically a gridlock,” said John McCain, R-Ariz.

Democrats had a more positive description of the scene playing out across the Capitol.

“This is just tedious hard work,” said Sen. Kent Conrad, D-N.D. “It’s just slogging through options.”