Medicare Rx Mark Up In July Remains Finance Cmte. Goal Under Baucus

Incoming Senate Finance Committee Chairman Baucus (D-Mont.) hopes to stick to the planned schedule to mark up Medicare prescription drug legislation during July, Finance Committee Democratic Counsel Elizabeth Fowler, PhD, told an Alliance for Health Reform briefing May 30 in Washington, D.C.

"We're still talking about marking up a prescription drug bill in July," Fowler said. "Hopefully that is still possible."

As a result of Vermont Sen. Jeffords' decision to leave the Republican party, Baucus will take over for Sen. Grassley (R-Iowa) as chair of the Finance Committee. Grassley wanted to move a bill through committee before the August recess (¹ ).

"The best chance for having a prescription drug bill this year would be to have a bipartisan package and I bet that we'll try to continue along that path," Fowler said. Baucus' staff has "been working with Sen. Grassley's staff since the beginning of the year on prescription drugs and uninsured," Fowler said. "I expect that that work will still continue."

Council of Economic Advisers consultant Mark McClellan, MD/PhD, suggested the relationship between Baucus and Grassley could be significant in lessening the impact of the changeover.

"The remarks that Chairman Grassley made...after an agreement had been reached on the tax bill about the pleasure he took in his close working relationship with Sen. Baucus...were notable," McClellan said. "We hope that that same kind of spirit is going to continue now that the Chairmanship has changed hands."

One significant hurdle to a Medicare Rx bill will be the budgetary impact, Fowler acknowledged. "I think we're still waiting for CBO." The Congressional Budget Office is expected "to have scores on drug proposals next week," Fowler said.

Another potential change is that the Finance Committee under Baucus may place a higher emphasis on expanding coverage for the uninsured, Fowler suggested.

"One difference maybe from last week to this week is that...we have a real special interest in the uninsured and we would like to see a bill move in that area as well as prescription drugs this year," Fowler noted.

The transition in the Finance/Health Subcommittee may have a more significant impact on the Medicare Rx debate than the switch from Grassley to Baucus atop the committee.

Sen. Rockefeller (W.Va.) is in line to replace Sen. Snowe (R-Maine) as chair following Senate reorganization.

During a recent Medicare Rx hearing, Rockefeller expressed frustration at the limited input he had on the issue under Grassley, and doubted that a bill would move on the schedule set by the Iowa Republican.

"If I had to bet right now, my guess would be that the hearing process in the Senate Finance Committee on prescription drug benefits has failed, as has the chance that we will produce something this year," he said. The priority, Rockefeller declared, should be helping support state efforts.

The Health Committee may also play a larger role in the Medicare Rx debate when Jeffords surrenders his chairmanship of the committee to Sen. Kennedy (D-Mass.) (² (Also see "PhRMA Staff Expansion May Help With New Medicare Rx Broker Baucus" - Pink Sheet, 28 May, 2001.)).

The transfer of control to the Democrats in the Senate will give Sen. Breaux (D-La.) a forum to continue to push his Medicare agenda as chairman of the Senate Special Committee on Aging. However, his influence in the Medicare Rx debate is unlikely to increase in comparison to his recent role as the key broker between moderate Democrats and the Republican majority on the issue.

The Breaux/Frist Medicare proposal, which Republicans in the Senate considered a good starting point for the Medicare debate, is not a favorite option of most Democrats, especially those from rural states.

Incoming Budget Committee Chair Conrad (D- N. D.) is one of the skeptics of the Breaux/Frist approach. He and Sen. Graham (D-Fla.) plan to introduce a revised version of the "Medicare Outpatient Drug Act" this year, with new elements of comprehensive Medicare reform added to the bill (³ (Also see "Medicare Could Offer "Two Or More" Defined Rx Benefits, Sen. Graham Says" - Pink Sheet, 26 Mar, 2001.)).