Drug Deals
The 2003 Medicare expansion shows how far the Bush-era GOP was from fiscal conservatism.


By 6 a.m., three hours after the vote began, a majority of House members had voted in favor of passage, so Hastert ended the vote with the tally 220–215 in favor. It was the longest electronically recorded vote in House history. Democrats were rightly outraged. Representative Steny Hoyer (D., Md.) complained, “Democracy is about voting. But just as you cannot say on the Tuesday of Election Day, ‘We’ll keep the polls open for 15 more hours until we get the results we want,’ we ought not be able to do it here.”

The acts of the Republican leadership resulted in a House Ethics Committee investigation. Different members of the Republican leadership had approached Representative Nick Smith (R., Mich.) to persuade him to switch his vote. Congressman Smith was retiring at the end of the term, and his son, Brad Smith, was running to replace him. Congressman Smith alleged that the House leadership promised to endorse Brad Smith and donate $100,000 to his campaign for Congress if he voted for the bill. When these overtures failed, according to Congressman Smith, Republican leadership began to threaten Brad Smith’s political career. “They said, well, if you don’t change your vote,” Congressman Smith recalled, “then some of us are going to work to make sure your son doesn’t get to Congress.”

Beginning in March 2004, the Ethics Committee conducted a six-month investigation into Congressman Smith’s allegations. The committee “publicly admonished” House Majority Leader Tom DeLay (R., Texas), Representative Candice Miller (R., Mich.), and Representative Smith — Delay because he had “violated House rules” when he “offered to endorse Representative Smith’s son in exchange for Representative Smith’s vote”; Miller for supposedly threatening to oppose Smith’s son if he voted against the bill; and Smith because he could produce no evidence that a $100,000 bribe had been offered.

The ethics committee also noted that two other congressmen, Randall “Duke” Cunningham (R., Calif.) and James Walsh (R., N.Y.), “made statements” to Congressman Smith, but “neither of those Members violated House rules.” The committee, which was evenly split between Republicans and Democrats, agreed not to take further action.

Congressional Republicans were not the only ones engaging in shenanigans. In 2003, the Senate allocated $400 billion for MMA in its first ten years. To make this allocation work, the Bush administration wanted the Congressional Budget Office to forecast MMA’s budgetary impact at less than that figure. According to Senator Hagel, “The $400 billion number was critical because that fit within the budget which most of us voted for.” The CBO issued several different scores during the legislative process. The CBO’s first score, of an earlier version of the bill, was $341 billion over ten years. By July of 2003, its score was $405 billion. Finally, in November 2003, it brought in an estimate of $395 billion, just under the wire.

Some questioned the quality of CBO’s scores. Richard Foster, Medicare’s actuary, projected MMA’s budgetary impact to be between $500 billion and $600 billion over its first ten years. But Foster’s numbers were stifled during the legislative process. Thomas Scully, a Bush-appointed Medicare administrator, allegedly threatened to fire Foster in an attempt to hide his higher projections.

Soon after MMA passed both houses of Congress, the higher cost estimates became public knowledge. The Bush administration revealed its own cost projections, estimating MMA’s cost at $534 billion over the first ten years. In September 2004, the Bush administration added another $42 billion to its cost estimates. In February 2005, CBO released a new estimate of MMA’s costs, at $795 billion from 2006 to 2015, and Medicare trustees calculated that Medicare Part D will cost $8.7 trillion over its first 75 years. In July 2004, CBO reported that MMA would “yield a net increase in deficits” of $394 billion over its first ten years, and that $131 billion in premium payments would only partially offset the costs of the law.

The conservative movement is very different today than it was ten years ago. It’s hard to imagine the majority of Republicans supporting a bill like this. Moreover, regardless of how one feels about the policies the MMA put into place, conservatives should be ashamed that an ostensibly conservative political party engaged in such behavior. The party needs to be both more thrifty and more ethical than it was a decade ago.

— Noah Glyn is an editorial intern at NRO.