AARP backs prescription-drug plan

WASHINGTON — Congressional Republicans' drive to redesign Medicare gained momentum yesterday when the nation's pre-eminent organization representing older Americans strongly endorsed the legislation.

But the battle over the bill, which would add prescription-drug benefits to Medicare, escalated as most Democratic presidential candidates, plus leading Senate Democrats, denounced the plan.

Officials of the influential AARP — who for months had said the congressional plan would offer seniors too little help in affording medicine — embraced it yesterday, beginning a large advertising blitz and asking their 35 million members to lobby their representatives in Congress.

The bill is not perfect, AARP Chief Executive William Novelli told The Associated Press, adding, "But the country can't afford to wait for perfect."

A broad coalition of health and business organizations also mobilized campaigns supporting the bill, and President Bush prepared to call wavering GOP lawmakers during his trip to Britain this week.

On the other hand, the AFL-CIO and several other groups called for the bill's defeat. The labor organization, which has 13 million members, said the plan would provide "skimpy drug coverage" and undermine Medicare.

With congressional leaders trying to settle the issue within a week, two groups of lawmakers will be especially important: about a dozen House GOP conservatives, who may decide the legislation does too little to encourage private-sector companies to participate in Medicare, and Senate Democrats, many of whom say it emphasizes private health plans so much that the 38-year-old program could be undermined.

The agreement would provide the 40 million seniors and disabled people on Medicare the first federal assistance in paying for prescription drugs. Starting in 2006, the government would subsidize separate insurance policies and private health plans that covered part of their drug costs. Patients could sign up for either one if they paid about $35 per month and a $275 yearly deductible.

In addition, the agreement would try to steer more Medicare patients into private health plans, including preferred-provider and health-maintenance organizations. Under a central compromise, part of the effort to steer people away from the traditional fee-for-service version of the program would take place through an experiment in six metropolitan areas in which the original program would be forced into a direct price competition against private plans.

Yesterday, John Rother, AARP policy director, said the organization had decided to support the plan after successfully nudging lawmakers in recent days to make several changes. Those provisions, he said, strengthened the extra assistance the government would give low-income Medicare patients and increased financial incentives intended to deter employers from dropping the drug coverage they provide retired workers once the federal benefit began.

In the end, Rother said, AARP reasoned that the bill was worthwhile in light of the drug assistance it would offer older people with low incomes, even if it did not offer as much help to other Medicare patients as polls show they want. "We can always build on it in the future," he said.

White House officials and congressional Republicans portrayed the AARP endorsement as potentially decisive in what they acknowledged could be close votes in both chambers. Leading Senate Democrats, however, played down the importance.

"Public opinion polls have long showed that seniors strongly oppose the kinds of radical changes to Medicare proposed in this legislation," said Senate Minority Leader Tom Daschle of South Dakota. "And when seniors see the details of the Republican plan, the AARP leadership will undoubtedly regret this ill-advised decision."

Sen. Edward Kennedy, D-Mass., widely considered the party's most influential senator on health matters, said AARP had erred, as he redoubled his attacks on the agreement. He singled out a provision that would allot private health plans $12 billion more than either the House or Senate envisioned in the Medicare bills they passed in June. He called the money "a slush fund" that would make Medicare patients "guinea pigs" in an untested form of care.

Several Democratic presidential candidates matched his tone. Sen. John Kerry of Massachusetts branded the agreement "a raw deal for America's seniors and a corporate giveaway for HMOs and drug companies." Retired Gen. Wesley Clark said, "The bill coming out of Congress violates the basic principle of the Hippocratic oath — do no harm."