What: All Issues : Health Care : Aid to the Chronically Ill : H.R. 1. Prescription Drug Benefit/Vote to Allow Consideration of the Conference Report on Prescription Drug Legislation. (2003 house Roll Call 666)
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H.R. 1. Prescription Drug Benefit/Vote to Allow Consideration of the Conference Report on Prescription Drug Legislation.
house Roll Call 666     Nov 21, 2003
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This vote was the fourth of five procedural votes which were held prior to a vote on final passage of the prescription drug bill. When Medicare was created in 1965, prescription drugs were not an essential component of patient care. However, medical advancements in recent decades have enabled doctors to treat a wide range of diseases and ailments with prescription drugs. But the costs of prescription drugs have skyrocketed and many seniors are now unable to afford the drugs they need to stay healthy. Legislative proposals aimed at expanding prescription drug coverage and reducing drug prices have been a fixture on the congressional agenda since 1999 but, until 2003, policymakers have been unable to reach a compromise on the issue because the two political parties have fundamentally different ideas about how to expand drug coverage and address the rising costs of prescription drugs. Republicans have typically favored approaches that would subsidize private insurance companies to provide the coverage, while Democrats have advocated for adding a prescription drug benefit to the Medicare program. Earlier in the year, both the House and the Senate completed action on their respective proposals to provide Medicare recipients with prescription drug coverage through private insurers (rather than through Medicare). The House and Senate versions of the legislation, however, were not identical and a conference committee was convened to reconcile differences between the two versions of the legislation. The conference committee produced a conference report, the final version of the legislation, and the conference report was reintroduced into the House and Senate for final passage. On this vote, Republican leaders sought passage of the rules of debate governing House consideration of the prescription drug conference report (before legislation can be considered in the House, a rule drafted by the House Rules Committee-a de facto arm of the majority party leadership-must be adopted to set the guidelines for debate). Progressives voted against the rules of debate based on their opposition to the conference report. Specifically, Progressives objected to what they characterized as a "donut hole" in drug coverage which was contained in the prescription drug conference report. The conference report, Progressives noted, would provide zero drug coverage to seniors for yearly drug expenditures above $2250 and below $4900; seniors would be required to pay full price for drug costs incurred within that gap in drug coverage under the Republican-drafted plan. Progressives characterized the coverage gap as irresponsible and mischievous lawmaking on the part of Republicans and argued that if Congress was serious about prescription drugs, then seniors should receive at least some drug coverage for all drug purchases regardless of their yearly expenditures on prescription drugs. Progressives also opposed language in the conference report which would create a pilot program to allow private health plans to compete directly with Medicare by 2010. In the view of Progressives, allowing private plans to compete directly with Medicare would reduce the quality of health coverage for the nation's seniors. In contrast to private insurance plans-which can drop an individual's coverage on a whim, limit a patient's treatment options to only those doctors and hospitals that have been approved by the insurance company, and provide unequal coverage to individuals based demographic or geographic data-the health coverage provided through Medicare applies equally to all seniors, is never reduced based on one's health needs, and allows seniors to choose their doctor and hospital. Conservatives supported the rules of debate and argued that the free-market provisions contained in the prescription drug conference report would reduce prescription drug costs and increase the drug coverage choices available to seniors. On a party-line vote of 225-205, the rules of debate governing consideration of the prescription drug conference report were adopted.

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