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Bush Lobbied Hard for Medicare Reform Victory - 2003-06-28

President Bush says changes to the federal health care plan will make it easier for older Americans to afford prescription drugs. The president pushed hard for legislation on an issue traditionally dominated by Democrats.

President Bush brought undecided members of his own party to the White House this week to press for their votes on a package of reforms to the federal Medicare program.

That presidential pressure may have made the difference, as the plan passed by just a one-vote margin in the House, setting the stage for the biggest expansion of Medicare in its 38-year history.

When Mr. Bush signs the bill into law, older Americans will get subsidized prescription drug coverage for the first time. That is a perennial political issue, usually dominated by Democratic candidates, who campaign against what they say is Republican indifference toward older, poorer Americans, who cannot afford prescription drugs.

With his political team already raising more money than all his Democratic challengers combined, Mr. Bush has added a potent domestic accomplishment to his re-election campaign, with the vote still 17 months away.

The changes to the Medicare program not only give more people access to prescription drug coverage. They also allow wealthier senior citizens to choose the enhanced benefits of managed care programs that cover things such as preventive care.

"The centerpiece of this approach is choice. Seniors should be able to choose the health care plans that suit their needs," the president said. "When health care plans compete for their business, seniors will have better, more affordable options for their health coverage."

Democrats initially opposed the plan because they said offering the choice of more benefits in more expensive managed care programs discriminated against those who cannot afford them.

The plans that passed Congress, and must now be reconciled between House and Senate negotiators, allow seniors to stay in the current Medicare system with the new prescription drug benefit. Low-income families would qualify for an additional subsidy, allowing them to choose a Medicare option that includes prescription drug coverage.