President makes rare veto threat

Lawmakers consider ways to counter cost of Medicare reform


WASHINGTON - President Bush issued a rare veto threat yesterday as he vowed to block any legislative attempt to shrink the prescription drug benefit in a Medicare reform law set to take effect next year.

At the swearing-in ceremony for Michael O. Leavitt, health and human services secretary, Bush responded to congressional critics upset by increased cost projections for the new drug benefit.

"I signed Medicare reform proudly, and any attempt to limit the choice of our seniors and to take away their prescription-drug coverage under Medicare will meet my veto," Bush said.

After Bush sent Congress his budget for the 2005-2006 fiscal year Monday, aides acknowledged that the estimated cost of providing prescription medicine to Medicare recipients had risen to $724 billion over the first decade the plan is in operation.

The cost projection is almost twice as high as the $400 billion figure Bush cited two years ago when he unveiled his prescription drug proposal in his 2003 State of the Union address. Shortly after Congress narrowly passed the Medicare-reform bill in November 2003, the administration increased the prescription drug cost to $534 billion.

Administration budget officials say the cost has risen because the benefit will be offered during all 10 years covered by the new projections from 2006 to 2015 while previous estimates were for earlier periods that included chunks of time before it was to take effect.

Bush said yesterday that the Medicare reforms would decrease health care costs by covering preventive medicine such as heart and diabetes screenings, and by paying for medicines that will prevent the need for surgery in many cases.

"Under the old system, Medicare would pay $28,000 for ulcer surgery, but not the $500 a year for the prescription drugs that eliminated the cause of most ulcers," he said. "That system didn't make sense for our seniors. It made no sense for American taxpayers."

White House press secretary Scott McClellan said Bush's veto threat was aimed primarily at Democratic lawmakers he accused of trying "to undermine the reforms that we put in place."

Bush is the first president since John Quincy Adams in the 1820s not to exercise the veto during his first term. At the same time, he used veto threats to gain concessions on legislation and cajoled fellow Republicans who control Congress to send him measures he could sign.

As Bush pushed the Medicare reform bill through Congress in 2003, he struggled to gain support from some Republican fiscal conservatives who were unhappy about the growing federal deficit and wary of creating a new entitlement program. The House passed the measure on a 220-215 vote, while the Senate voted 54-44 in favor.

When the higher cost projections emerged this week, some prominent Republicans joined many Democrats in criticizing the increase. Sen. Judd Gregg, a New Hampshire Republican and chairman of the Senate Budget Committee, raised the prospect of adjusting the prescription drug benefit.

"I do think we are going to have to go back and readdress it," Gregg said.

Rep. Jeff Flake, an Arizona Republican who voted against the original bill, said he and other lawmakers would consider drafting new legislation limiting the drug benefit to low-income seniors.

"If he chooses to veto this, that's his choice," Flake told Congressional Quarterly. "But I don't think he will."

Sens. John McCain of Arizona and Olympia J. Snowe of Maine, both Republicans, and Edward M. Kennedy, a Massachusetts Democrat, are leading a bid to repeal the law's ban on the government negotiating with pharmaceutical firms to get lower drug prices for Medicare recipients.

Other lawmakers want to remove a prohibition against seniors importing cheaper medicines from other countries.

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