Legislative Lowdown: Senators Make Bid to Delay Prescription Drug Plan

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  • 08/20/2022

This week saw a dramatic development in the maturing effort to
implement the “Katrina Doctrine” (the President’s call for Congress to
pay for the recovery costs associated with the recent hurricanes
through offsetting spending cuts).

Fiscal conservatives cheered
as a courageous group of seven Republican senators—Tom Coburn (Okla.),
John McCain (Ariz.), John Ensign (Nev.), John Sununu (N.H.), Sam
Brownback (Kan.), and Jim DeMint and Lindsey Graham of South
Carolina—unveiled an aggressive package of spending cuts that would
save as much as $115 billion over the next two years.

themselves the “Fiscal Watch Team,” their most ambitious proposal is to
delay for two years the most expensive portion of the new Medicare
prescription drug plan, which would underwrite the prescription drug
costs for all 40 million seniors, rich and poor alike. Set to go into
effect in January, this benefit would be the single largest expansion
of an entitlement program ever.

The senators make the
politically shrewd suggestion that the relatively inexpensive ATM-like
prescription drug discount cards now in use by millions of lower-income
seniors continue, with Uncle Sam’s doubling the amount it contributes
to the cards of the poorest seniors to $1,200. By not subsidizing the
prescription drug costs incurred by millions of middle- and
upper-income seniors, the savings to taxpayers would exceed $40

Fiscal Sanity

With Medicare’s cost expected to rise by an astounding $50 billion next
year, from $290 billion to $340 billion in 2006, the senators view the
controversial benefit as an essential ingredient in their recipe to
restore fiscal sanity.

What are the chances that such a radical
proposal, one that would eviscerate the very program the President
points to as his defining domestic policy achievement, might prevail on
the Senate floor? My own review of the prospects for this idea suggest,
surprisingly, that it’s anything but a pie-in-the-sky notion.

conduct a modest thought experiment to assess the prospects for the
senators’ Medicare proposal and assess whether it might attract the
essential 51 votes:

We start with the seven Republicans who
signed on to the spending plan. It’s important to note that one of
these senators, Brownback, supported the drug benefit in 2003. Total: 7.

Republican Senators Chuck Hagel (Neb.), Trent Lott (Miss.), Judd Gregg
(N.H.) and Lincoln Chafee (R.I.). Each voted against the benefit in
2003, fearing its long-term fiscal consequences. The liberal Chafee’s
logic in opposing the benefit may come as the biggest surprise.
“Expanding an entitlement,” he said then, “is going to add to the
deficits.” Total: 11.

Add Sen. Jeff Sessions
(R.-Ala.), who, regretting his support for the benefit, led an effort
in 2004 to cap the new program’s outlays. Sessions ranks as among the
most stalwart fiscal conservatives in the Senate. Total: 12.

Whip Count

Sen. Richard Burr (R.-N.C.), who as a House member initially voted
against the House-passed version of the program before ultimately
supporting the final deal. Burr possesses an admirable rebellious
streak when it comes to spending, as evidenced by his recent support of
Coburn’s effort to redirect funds from the infamous Alaska “bridge to
nowhere” to a Louisiana bridge damaged by Hurricane Katrina. Total: 13.

the 35 liberal Democrats and Sen. Jim Jeffords (I.-Vt.), who also
opposed the benefit, although for an entirely different set of reasons
(they argued the benefit should have been considerably larger). Of
course, they may very well reason that even an inadequate benefit is
better than no benefit at all, but opposing the Fiscal Watch Team’s
proposal would place them in the potentially unwelcome political
position of voting for the benefit after having first opposed it.
Arguably, the proposal’s protection of low-income seniors could provide
enough protective coloration to enable these Senate liberals to align
with their ideological polar opposites. Total: 49.

all this come to pass, the Fiscal Watch Team would then need to attract
the votes of only two additional senators. The 11 Democrats who
supported the benefit in 2003 hail largely from conservative “red”
states such as Nebraska, Montana, the Dakotas, Arkansas and Louisiana
and certainly would be fair game, given the extent to which fiscal
concerns have come to the forefront in these states.

freshman moderate Sen. Ken Salazar (D.-Colo.), Sen. Joe Lieberman
(D.-Conn.), and any of a number of Republicans who, like Brownback, may
have developed misgivings over the $8.7 trillion that the benefit will
add to the nation’s unfunded debt, and a winning floor strategy may not
be as far-fetched as one might think.


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