Did anyone ever doubt that Medicare Part D — President Bush’s famed universal prescription-drug benefit for senior citizens — was intended primarily as a political tool? If you ever did, look to the front page of Friday’s Washington Post and doubt no longer.
Now that Congress is in Democratic hands and any positive reforms will be impossible, President Bush is finally calling for an income limit — a so-called “means test” — for the program that he went to such great lengths to pass in 2003 without a means test over opposition from conservatives.
For context, look back exactly seven years ago to October 3, 2000. Texas Gov. George W. Bush was struggling in his debates against Vice President Al Gore, the champion of a universal prescription-drug benefit for senior citizens. Gore believed that he had Bush on the ropes with the issue of senior citizens and prescription-drug prices. “Well, Jim,” he said, “under my plan all seniors will get prescription drugs under Medicare.” (If you recall, Gore even went so far as to fabricate a sob story about a woman gathering aluminum cans to pay for her drugs.)
But Bush had been advised by his handlers to salve the wound by matching Gore’s bid: “I want all seniors to have prescription drugs in Medicare,” he said. “All seniors will be covered, all seniors will have their prescription drugs paid for, and in the meantime, we’ll have a plan to help poor seniors and in the meantime it could be one year or two years.” This was the famous exchange in which he accused Gore of “Medi-scare” and “fuzzy math.”
The story from there is familiar. In the election of 2002, Republicans solidified their control of the House and re-took the Senate. Beginning in the summer of 2003 and ending with a final vote in late November, President Bush used all of his might to force a universal prescription drug bill through Congress that would not take effect until 2006.
Bush was heedless of conservatives’ warnings that this bill represented the largest new entitlement program in decades. He ignored arguments that young people, struggling to pay off college loans and establish themselves in their professions, should not be forced to pay billions so that senior citizens — the nation’s wealthiest demographic — could enjoy the luxury of not paying most of their prescription drug costs.
Conservatives alleged bribery and bullying by the House leadership and the administration over the course of two extended roll call votes on the House floor, one of which lasted three hours. According to Robert Novak’s column of November 27, 2003, “Major contributors warned Rep. Jim DeMint they would cut off funding for his Senate race in South Carolina” unless he reversed course and voted for it. “A Missouri state legislator called Rep. Todd Akin to threaten a primary challenge against him.”
At one point on the House floor, the now-disgraced bribe-taker Duke Cunningham (R., Calif.) taunted conservative holdout Nick Smith (R., Mich.) for his “no” vote. He said that Smith’s son, a candidate for Congress in Michigan in 2004, was “dead meat” as a result.
The administration shot down repeated attempts by conservative congressmen to add a means test to the program, both before and after the bill first passed on June 26, 2003. “There is no reason in the world why we ought to be paying the prescription drug benefits for the wealthiest in society, the Bill Gates, the Barbra Streisands, the Ted Turners, the Warren Buffetts,” said Rep. Jeff Flake (R., Ariz.). His argument to instruct conferees to add a means-test went nowhere: the proposal withered in the face of the administration and Democratic opposition.
In the end, Bush got his bill as he wanted it — with no means test for benefits.
Three years later, with Congress in Democratic hands and no legitimate chance of passing any changes, the Bush administration appears to have rediscovered fiscal responsibility. The Washington Post reported on its front page Friday that Bush is cooperating with Sen. John Ensign (R., Nev.) to propose a means test for Medicare Part D. Seniors making more than $82,000 (or double that for married couples) would have to pay more in premiums along a sliding scale. As it is written now, the measure would save something less than $10 billion over five years.
This March, Ensign (who voted against the bill but for cloture in 2003) tried to attach the same proposal to the Senate budget, which failed on a 52-44 vote. Not a single Democrat supported it, and there is no reason to think that any of them will support it now.
What is the president doing? Why has he waited until now for a reform that would have passed easily in the first place through the Republican Congress, had it been his original proposal? Bush’s sudden call for a means test can be interpreted in two different ways.
The first interpretation — the more charitable one — is that Bush has realized his prescription-drug program was a huge mistake, costing too much money, and must be altered. But a White House denied such an admission, claiming instead that the means-test “is a question of fairness.” (No answer was forthcoming as to why Bush insisted on an “unfair” bill in the first place.) Even so, it is too late now for a change of heart. As the Post article notes, the AARP will not stand for it — wealthy seniors are not about to stand by idly as their free lunch is taken away.
The second interpretation is that the president is playing a cynical game of pretend fiscal responsibility. When he had a Republican Congress, Bush could have done something more responsible. Instead, he pushed through a bill that his strategists thought would prove to be good politics, at the expense of conservative principle. Now, suffering from record-low popularity and butting heads with a Democratic Congress, he hopes to energize conservatives by blaming Democrats for keeping his own bill as he wanted it originally.
It’s not a promising legacy.
— David Freddoso is a National Review Online staff reporter.