Agency Sees Withholding of Medicare Data From Congress as Illegal
WASHINGTON, May 3 ? The Congressional Research Service says the Bush administration apparently violated federal law by ordering the chief Medicare actuary to withhold information from Congress indicating that the new Medicare law could cost far more than White House officials had said.
In a report on Monday, the research service said that Congress's "right to receive truthful information from federal agencies to assist in its legislative functions is clear and unassailable." Since 1912, it said, federal laws have protected the rights of federal employees to communicate with Congress, and recent laws have "reaffirmed and strengthened" those protections.
The actuary, Richard S. Foster, has testified that he was ordered to withhold the cost estimates last year, when Congress was considering legislation to add a drug benefit to Medicare. The order, he said, came from Thomas A. Scully, who was then the administrator of Medicare.
Mr. Foster said Mr. Scully threatened to discipline him for insubordination if he gave Congress the data.
The research service, a nonpartisan arm of Congress, said Mr. Scully's order "would appear to violate a specific and express prohibition of federal law." The actuary, it said, has a duty to "make professional and reliable cost estimates, unfettered by any particular partisan agenda."
In March, Bush administration officials suggested that they would provide the actuary's cost estimates to Congress. "We have nothing to hide, so I want to make darn sure that everything comes out," Tommy G. Thompson, the secretary of health and human services, said on March 16. But a month later, in a letter to Congress, the administration refused to provide the documents.
Mr. Scully has confirmed telling Mr. Foster that "I, as his supervisor, would decide when he would communicate with Congress."
William A. Pierce, a spokesman for the Department of Health and Human Services, said on Monday that the propriety of Mr. Scully's action was being investigated by the agency's inspector general. In any event, Mr. Pierce said, "we are looking to the future, not the past."
On Monday, the administration opened a campaign to persuade millions of older Americans to sign up for prescription drug discount cards.
Secretary Thompson said Medicare beneficiaries nationwide would have access to at least 39 cards offering savings of 10 percent to 25 percent off the retail prices charged to people without drug insurance.
"For the first time," Mr. Thompson said, "we are going to pool the purchasing power of Medicare beneficiaries to drive down the prices they pay for prescription drugs." Before choosing a card, he said, beneficiaries should carefully compare the prices available with different cards for the drugs they use.
Mr. Thompson said beneficiaries could start using the cards next month and could continue using them until January 2006, when Medicare's drug benefit begins.
A big challenge for beneficiaries is to overcome the confusion surrounding the new cards. Sponsors of the discount cards said that many of the prices posted on the official Web site,
www.Medicare.gov, were still incorrect ? an assertion disputed by Mr. Thompson ? and some sponsors were quoting prices different from those posted by the government.
Neil D. LaGrow, 80, of Culpeper, Va., who said he spent $890 a month on 15 medications, predicted that the discount cards would be "tremendously helpful."
Howard J. Bedlin, vice president of the National Council on the Aging, a research and advocacy group, said the cards would be "very valuable" to low-income people. Individuals with annual incomes of $12,569 or less and couples with incomes of $16,862 or less will be eligible for a credit of $600 a person on their cards.
In addition, Mr. Bedlin noted, some major drug companies, like Merck and Novartis, have said they will offer their medicines at no charge or for a very small fee to low-income people who use up the $600 credit. Moreover, he said, some states will pay drug costs for low-income people who exhaust the $600 allowance.
For people with incomes above the thresholds, Mr. Bedlin said, the value of the discount card will vary, depending on what drugs they take.
Congressional Democrats said the savings would prove illusory for most beneficiaries.
"This sounds like a good deal, but it isn't," said Representative Nancy Pelosi of California, the House Democratic leader.
Representative Pete Stark of California, senior Democrat on the Ways and Means health subcommittee, said: "The cards provide maximum confusion and minimal savings. These deep discounts were a figment of the Republicans' imagination."
Prices available with the new drug cards are, in many cases, higher than those available to any consumer using online pharmacies.
Peter M. Neupert, chairman of drugstore.com, said: "In general, our prices are lower than those offered by many of the Medicare card sponsors. Our operating costs are a bit lower than those of bricks-and-mortar drugstores."
In addition, Mr. Neupert said, his company's Web site is easier to use than the new Medicare site.
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