WASHINGTON – Republican leaders cleared a prescription drug bill for House debate Thursday even as they tried to shore up votes among rank-and-file members.
The House approved rules for debating the bill, which would spend $350 billion over 10 years. Debate was expected later in the day following action on two unrelated spending bills.
In one slight change in the prescription bill, Republicans agreed to require seniors to pay premiums of $33 a month -- $2 less than the earlier version required.
Thursday's vote is expected to be extremely close in the House, where Republicans only hold a slim 11-vote margin over Democrats.
Party leaders spent Wednesday trying to win over votes from GOP members, some still vehemently opposed to creating a new benefit and others wanting special benefits for hospitals in their states.
"We never have the votes until we're ready to move the bill," Speaker Dennis Hastert, R-Ill., said as he emerged from the meeting.
Negotiations made some progress Wednesday, aides said. The Ways and Means Committee agreed to drop a $40 copayment for home health patients. The Energy and Commerce Committee, which also has jurisdiction over the issue, had balked over that provision.
Republican leaders also agreed to a $3,700 cap on out-of-pocket spending. The Ways and Means Committee had offered a cap that was $100 higher.
Still, the bill that GOP leaders had touted early on as a comprehensive Republican plan, has drawn its share of criticism from within the party.
Among those seeking changes:
--Rep. Gil Gutknecht, R-Minn., wants a provision that would allow the importation of U.S.-made pharmaceuticals sold more cheaply abroad.
--Rep. Jo Ann Emerson, R-Mo., wants to revise rules for patent protections to encourage access to low-cost generic drugs.
--Rep. John Peterson, R-Pa., wants to expand to other states a provision giving extra money to hospitals in 14 states.
--Rep. Donald Manzullo, R-Ill., chairman of the Small Business Committee, is concerned that the bill would harm small pharmacies.
--The New Jersey delegation wants more money for hospitals in that state, saying they get fewer Medicare dollars than nearby New York and Pennsylvania
Yet another GOP lawmaker, Rep. Mac Collins of Georgia, said he opposes the universal entitlement approach of the prescription drug plan and would rather see a program that helped only the neediest seniors.
"I cannot support either plan currently being debated in Congress," Collins said, referring to separate proposals by Republicans and Democrats.
The GOP bill would spend $350 billion over 10 years and rely primarily on private insurers to administer the benefits. It would require seniors to pay premiums of about $33 a month along with a $250 yearly deductible.
The government would pay 80 percent of the first $1,000 of drug costs and 50 percent of the next $1,000. Patients would be responsible for drug costs beyond that, although there is a $3,700 cap on out-of-pocket spending.
The House Democratic plan would spend more than double the Republican proposal.