View from Washington: First Steps

What the Democrats’ health policy agenda will look like.

Democrats are mobilizing to take advantage of their wins in the U.S. House and Senate, on election night 2006, and have already drafted an ambitious healthcare agenda to implement in the coming terms. Their agenda includes providing more money for the children’s health insurance program, expanding stem cell research, and increasing funds for the National Institutes of Health.

One of the highest priorities for the Democrats is the elimination of the prohibition – contained in the 2003 Medicare Modernization Act – for the federal government to negotiate with pharmaceutical companies for lower Medicare drug prices. They plan to address this issue within the first 100 hours. Democrats strongly believe that government negotiations could save Medicare serious money. Drug manufacturers, however, say the business reality of such a proposal is that drug prices would actually increase across all classes of trade. Additionally, discount prices to government and non-government programs would be reduced. Budget projections provided by the non-partisan Congressional Budget Office (CBO) support the industry’s message that savings to Medicare will not increase. Specifically, a CBO analysis states, allowing the federal government to negotiate prices would have a “negligible effect on federal spending.” President Bush has indicated that he would veto any measure allowing the federal government to directly negotiate drug prices.

Another item high on the agenda list is the new drug benefit offered by Medicare. Democrats would like to close the coverage gap or “doughnut hole,” reduce qualification requirements for extra assistance for low-income people, eliminate the late enrollment penalty, and offer one or more government-administered prescription drug plans. According to Democrats, funding for these provisions would come from the savings offered by allowing the federal government to negotiate drug prices.

There also appears to be a long list of federal agencies and programs that various Democrats want to investigate using the subpoena power that comes with their anticipated committee chairmanships, including drug prices and various pharmaceutical marketing practices. With control of the House and Senate, there is one word that captures the Democratic agenda for the next two years: “OVERSIGHT.”

With the majority in both chambers, Democrats will push their legislative proposals and try to win over some Republicans who have voted for more liberal approaches in the past, such as to allow federal funding for stem cell research, might potentially vote to override President Bush’s anticipated vetoes. With Democratic wins in Congress, by virtue of his veto power, President Bush has suddenly become the next relevant politician regarding the health policy agenda.

About the Author

Robert Betz Ph.D.
Robert Betz, Ph.D., is president of Robert Betz Associates, Inc. (RBA), a well-established federal health policy consulting firm located in the Washington, D.C. area. Additionally, Dr. Betz is an adjunct professor teaching at The George Washington University where he specializes in political science and health policy. For more information about RBA, visit www.robertbetz.com.
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