When C.A. Dutch Ruppersberger stopped by Oak Crest Village on Tuesday, looking for votes in the huge Parkville retirement community, Maurice Preston corralled the congressional candidate to talk about two things: golf and prescription drugs.
Preston's wife, Dorothy, had a stroke 11 months ago. The 83-year-old is recovering -- she gets around with a walker -- but her prescription drug costs continue to rise, even with their AARP discount program.
"Most seniors talk about the same damn thing, and nothing is being done about it," said Maurice Preston, 83. "There are a lot of people here with a lot of money, but prescription drugs just keep going up."
The debate over how to pay for prescription drugs has become one of the clearest divides in the race for Maryland's 2nd Congressional District.
Democrat Ruppersberger and his Republican opponent, former Rep. Helen Delich Bentley, are taking their cues and talking points from their parties as they back competing plans for adding a prescription drug benefit to Medicare.
"We're one of the richest nations in the world, and it's just not right when our seniors are retired and now need help," Ruppersberger said. "The Republican plan has no teeth in it and doesn't really help the problem."
Bentley said the proposal she supports has major advantages over the Democratic plan. It has passed the House of Representatives and has the support of President Bush, and funding for it is included in federal budget plans.
"I believe that is a sound first step. However, the Democrat-controlled Senate apparently is not going to do anything about making it become a reality," she told a group of seniors at an AARP forum last month.
"I am a senior; I know what it means. The House has done its job; the Senate needs to do its job."
Ruppersberger has also tried to make an issue of Republican efforts to make Social Security partly private, saying that would put seniors' retirement income at risk through investments in the stock market.
Bentley has largely defused the attack by agreeing that the Social Security system should not be changed.
Both have said they favor extending health insurance to more seniors, though neither has offered many details on the issue.
House OK'd GOP plan
The House passed the Republican prescription drug plan June 28 on a largely party-line vote. Republicans did not allow a competing House Democratic plan to come to a floor vote.
The Senate has debated several proposals. Though Bentley criticizes Senate Democrats for keeping a bill from passing this year, seniors would not receive immediate relief in any case because neither the House Republican plan nor the Democratic proposal would take effect until 2005.
The Democratic plan would cost seniors less. They would pay a $25 monthly premium and a $100 annual deductible to enroll. Republicans estimate that the premium for their plan would be $33 a month with a $250 deductible.
The Democratic plan offers more generous benefits but would be much more costly to taxpayers.
The Republican plan would cost the government about $320 billion from 2005 to 2012. Cost estimates for the Democratic plan range from $800 billion to $973 billion during that time. Funding for the Republican program is included in the current 10-year federal budget plans. Democrats have not united behind a plan to pay for their proposal.
On the stump, Ruppersberger has said he would pay for it the same way he has handled tough budget questions as Baltimore County executive: by setting priorities and making tough decisions.
He hasn't said what he would cut to pay for the drug coverage. In an interview, he said he would need to get to Congress and thoroughly review federal programs before deciding.
Split over funding
He added that he would consider rescinding the Bush tax cut of last year, which he said did little for most Americans.
"If that means that would help pay for prescription drugs for seniors, then I would take a very strong look at that at this point," Ruppersberger said. "That to me is one of the highest priorities right now, other than the basic, everyday running of the government and the security of our nation."
Bentley said that as the nation fights terrorism, creates the Homeland Security Department and tries to implement the No Child Left Behind Act, spending that much on prescription drugs isn't possible.
"It's fine to include these fancy figures, and we're going to do this and that, but if there's no revenue stream, there ain't no money to pay it out," she said.
The other major difference between the plans is that the Democrats would have benefits provided by the government, as is the case with traditional Medicare, and Republicans would pay private insurers incentives to offer the policies to seniors.
Republicans argue that private insurers can provide more flexibility, better benefits and a lower cost than the federal government, which they called a bloated bureaucracy.
Democrats say the Republican plan doesn't guarantee uniform premiums and benefits.
Ruppersberger has said several times during campaign appearances that under the Republican plan, private insurers could turn down seniors for coverage, but congressional officials from both parties say that's not true.
The AARP has expressed skepticism about the idea of giving private insurers incentives to offer the coverage.
The organization's lobbyists argue that because individual insurance companies would be able to decide from year to year whether to offer the coverage and how to structure their plans, the program would lack stability.
Tricia Neuman, head of the Kaiser Family Foundation's Medicare Policy Project, said focus groups have found that the details of a prescription drug benefit aren't as important to seniors as their primary interest, the price of premiums.
"It's complicated to find out what cost-sharing and deductibles and stop-loss really mean," she said. "But a premium is something people understand how to budget."