Senate Not Buying House Line On Medicare Part D Changes

The Senate is seen as likely to act relatively promptly to amend legislation governing the prescription drug benefit under Medicare, but the sweeping modification to the program passed by the House appears to have little support.

The House on Jan. 12 approved legislation that directs the government to negotiate prices for the prescription drug program under Medicare directly with manufacturers. The final vote on the legislation, H.R. 4, was 255-170, with 24 Republicans joining all 231 Democrats who participated. A few minutes earlier, Republicans failed to kill the bill through a motion to recommit, 196-229.

But the vote is regarded as symbolic because the administration had previously issued a statement in which it said that if the bill as passed by the House reaches the president’s desk, he would veto it.

Sen. Max Baucus, D-Mont., chairman of the Senate Finance Committee, signaled at a panel hearing on the issue that he would not support the House legislation. And Sen. Charles Grassley, R-Iowa, former chairman and ranking minority member of the panel, said he would filibuster legislation containing such a mandate, but would look for common ground with Baucus on more modest improvements to the program.

In his comments, Baucus said he would most likely merely endorse legislation that would remove language in the 2003 act creating the prescription drug program that bars the government from negotiating directly with pharma manufacturers.

“The ‘non-interference clause’ in the original Medicare Modernization Act is prohibiting us from pursuing constructive efforts to make the benefit work better for seniors,” Baucus said. “The total prohibition on negotiation should be eliminated.”

But, Baucus said, “I see nothing that warrants heavy-handed intervention in this market. We should proceed cautiously with any legislation. But we should proceed nonetheless.”

He explained, “It is clear to me from today’s testimony that there are areas of the drug benefit in which market competition is not working. In some cases, the private market may be failing to provide seniors with the affordable medicines this benefit has promised.”

Taking a middle ground, Baucus said that he “doesn’t buy the argument that the sky will fall on the prescription drug market if we remove this clause.”

He noted that the Secretary of Health and Human Services “has a goldmine of data, the ability to get more data, dozens of agencies, and tens of thousands of public servants at his disposal.

“That is quite a tool box with which to seek fair drug prices for seniors,” he added. “It is time to open that tool box for Medicare.”