The Senate on Tuesday scuttled rival bills to provide prescription drug coverage for 34 million Medicare recipients, leaving the politically charged issue in limbo little more than 100 days before midterm elections.
Democrats and Republicans alike spoke optimistically of a hurry-up stab at compromise — at the same time they maneuvered for election-year advantage.
Without a breakthrough, warned Sen. John Breaux, D-La., senior citizens will wind up with "excuses that they can't take to the drugstore."
The first bill to fall was crafted by Democrats to create a new government-run prescription drug benefit for the 34 million older Americans served by Medicare, at a cost estimated at $594 billion over several years.
Republicans challenged the measure under the Senate's budget rules, and the vote was 52-47, eight short of the 60 needed to advance.
Next came a "tripartisan" measure from Republicans joined by Breaux and Sen. James Jeffords of Vermont, the Senate's only independent. Challenged by Democrats, it fell on a vote of 48-51, 12 short of the 60 needed.
That plan envisioned a less expensive program than the Democratic blueprint, with coverage offered through private companies at a cost estimated at $340 billion. The measure devoted an additional $30 billion to create an optional alternative to traditional fee-for-service Medicare.
Both bills offered government prescription drug subsidies for low-income patients, as well as coverage for any Medicare recipient willing to pay, but they differed widely in the details.
Democrats repeatedly said GOP opposition to a government-run benefit echoed Republican objections when Medicare was created 36 years ago.
Senate GOP Whip Don Nickles, R-Okla., had no sooner finished criticizing the Democratic measure than Sen. Tom Harkin, D-Iowa, said it was too bad the Oklahoma Republican wasn't in the Senate in 1965. "He could have joined the chorus of voices — voices on that side of the aisle — that argued against Medicare. He'd have fit right in," Harkin said.
Nickles, standing a few feet away on the Senate floor, shot back, "I wonder why you're guessing what I might have done in 1965."
"I'm not guessing," retorted Harkin, saying he was extrapolating from Nickles' comments on prescription drug legislation.
Key Democrats met with Jeffords within hours of the votes on the Senate floor in hopes of fashioning a measure that could command 60 votes. They arranged to expand their effort to include a few key Republicans on Wednesday.
One congressional source, speaking on condition of anonymity, said the discussion centered on creating prescription drug coverage through private companies, but at a guaranteed level of benefit. Additionally, the government would be empowered to provide coverage if no private market developed. The price tag under discussion was in the range of $500 billion, this source said — more than key Republicans have said they could accept.
"Everything's on the table," said Majority Leader Tom Daschle, D-S.D., although he said it was "important that we maintain a Medicare program." In a further jab at Republicans, he added, "The majority of the members (of the Senate) have said 'yes' to a real benefit" — a reference to the 51 votes gained by the Democratic alternative.
Sen. Charles Grassley, R-Iowa, said he, too, was "willing to sit down and listen" to proposals for a compromise. At the same time, he attacked the Democratic alternative as too costly and temporary as well and said the Senate split broke down into a battle between "those who want a good benefit versus those who want a campaign issue."
Further complicating hopes for a compromise, Senate GOP leader Trent Lott, R-Miss., said he couldn't support any legislation that cost more than the $370 billion in the alternative to the Democratic proposal.
The votes on the Senate floor were choreographed in advance — each side well aware that both measures would fall short of the 60 votes needed. The Democratic proposal drew the support of all 50 members of the party's rank and file, as well as Jeffords and Sen. Peter Fitzgerald, R-Ill.
The alternative won the backing of 45 Republicans, Breaux, Sen. Mary Landrieu of Louisiana and Jeffords.
Sen. Olympia Snowe, R-Maine, a leading supporter of that bill, expressed unhappiness at the procedure that Daschle had established — no formal hearings or debate in the Senate Finance Committee, no opportunity to amend either proposal. "We didn't act like the world's greatest deliberative body," she lamented.
Sen. Edward M. Kennedy, D-Mass., present in the Senate when Medicare was created in 1965, said the prescription drug legislation was long overdue.
Under the Democratic bill, he said: "there is no deductible, there are no gaps, there are no loopholes. The benefit and the premium are both guaranteed in the law itself. Low-income senior citizens get special assistance."
Supporters of the alternative noted that the cost of the Democratic measure was $600 billion over 10 years — and that the benefit would not begin until 2005 and end in 2010. "Our plan is comprehensive, affordable, sustainable into the future," said Jeffords. "It will provide seniors with an important drug benefit, at an affordable cost."
The Republican-controlled House passed legislation this year on a largely party-line vote to provide coverage under a program of private insurance.