Actuary for Medicare endures media glare

Issue: Marylander stays cool as politicians spar over his gloomy projection of the cost of revamping the medical insurance program.

March 26, 2004|By Cyril T. Zaneski | Cyril T. Zaneski,SUN STAFF

WASHINGTON - If Richard S. Foster were an actor, he'd be typecast as a World War II British wing commander - ramrod straight in bearing and sporting a thick, gray mustache over a stiff upper lip.

Foster, who is Medicare's chief actuary, displayed a movie hero's unflappable cool this week as he found himself in the political hot spot between Republicans and Democrats battling over what could be this election year's biggest domestic issue, the future of the medical insurance program for 41 million American seniors.

He told a congressional panel Wednesday that a Bush administration official had threatened to fire him last summer if he revealed to Congress that his projected cost of a White House plan for revamping Medicare far exceeded the $400 billion price tag that the administration hung on the legislation.

Throughout a three-hour hearing, the stone-faced Foster sat straight and answered questions without hesitation in a soft, steady baritone.

At issue: What measures did the Bush administration take to steer the Medicare Modernization Act through Congress? In January, a month after President Bush signed the legislation, the administration released Foster's $534 billion cost estimate - six months after Foster said he provided those numbers to the White House and top officials at the Department of Health and Human Services.

Foster, 55, said in an interview yesterday that he considered resigning in protest of the gag order last summer but stayed on to protect the 70-member actuarial team that he leads at the Centers for Medicare and Medicaid Services headquarters in Baltimore.

"I struggled really hard last year with what would be the best thing to do," Foster said after a forum that examined Medicare finances here. "The best I can say about it was that this whole experience has been nightmarish. I am going to be very happy to go back to relative obscurity."

Before the current uproar, Foster was known for writing incisive articles on Medicare and Social Security, including, "A Stochastic Evaluation of the Short Range Economic Assumptions in the 1994 OASDI Trustees' Report" and "Level of OASDI Trust Fund Assets Needed to Compensate for Adverse Contingencies." OASDI, by the way, stands for Old Age and Survivors, and Disability Insurance, which is the official name for Social Security.

Foster's stature as a faceless technocrat melted in recent weeks as articles about Bush administration efforts to muzzle him during last year's congressional debate over Medicare were displayed on the front pages of newspapers and kicked around by television pundits.

His accusation that Medicare chief Thomas A. Scully threatened to fire him is under investigation by the HHS inspector general. Scully, who left the government in December, has denied the allegation.

Under the spotlights at the House Ways and Means Committee, lawmakers grilled Foster about his analyses that predict bankruptcy for Medicare's hospital trust by 2019 and a separate trust that will pay for a new prescription benefit and other services taking ever larger bites out of the federal budget.

The panel's questioning Wednesday was fiercely partisan, with Republicans casting Foster's work on the Medicare bill as no better than lower estimates by the Congressional Budget Office and Democrats portraying Foster as a victim of a White House campaign to mislead Congress about the costs of its primary domestic initiative.

"There was a cover-up of some basic information," said Rep. Sander M. Levin, a Michigan Democrat. "Not having all the facts is a big deal."

Meanwhile, Democratic Sens. Hillary Rodham Clinton of New York, Frank R. Lautenberg of New Jersey, Edward M. Kennedy of Massachusetts and Debbie Stabenow of Michigan alleged this week that the Bush administration may have broken laws by keeping Foster's work from Congress. In a letter to Attorney General John Ashcroft, the senators said the laws prohibit the use of "threats or force" to impede the work of Congress and bar federal employees from intentionally concealing a "material fact" related to a matter before Congress.

Support from colleagues

Foster's colleagues have stood behind him. During the hearing, actuaries for Social Security and the Congressional Budget Office expressed support for Foster's work. Gail Wilensky, who served as Medicare chief under President George Bush and advised his son on health issues during the 2000 presidential campaign, praised Foster's independence during a panel discussion on Medicare yesterday.

"Whatever else has gone on," she said yesterday, "the numbers in his report are as he believes them to be true."

The political hubbub set Foster up for ribbing from colleagues yesterday at the American Enterprise Institute's annual discussion of Medicare's financial state. Robert Reschauer, president of the Urban Institute and former director of the Congressional Budget Office, cautioned panel members about challenging Foster's work, "now that Rick has ascended to Mother Teresa status."

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