Prescription for Friction

Oct. 13, 2006— -- When you're getting a flu shot or a checkup at your doctor's office, your state representatives and senators might not be on your mind. But perhaps they should be. Health care is inseparable from politics in America, and your government leaders have a real say in how you get your medical care.

President Bush's health-care agenda has focused on health savings accounts, expanded community health centers, and a prescription drug benefit under Medicare. He is currently pushing medical malpractice reform and making HSAs available to more Americans.

When Bush signed the Medicare prescription drug bill into law, many Republicans thought the legislative move would take health care "off the table" in the next round of elections, but its actual effect has been mixed.

Its high cost has left true-blue conservatives feeling that the GOP has abandoned its identity as the party of limited government. Meanwhile, Democrats are savoring the thought of seniors hitting the program's "donut hole" coverage gap some time between now and November.

Democrats are also planning to make the GOP's decision to bar Medicare from negotiating for lower drug prices part of its "Six in '06" legislative agenda. Republicans answer these charges by saying that the GOP has pursued a "market-based" approach; Republicans also accuse Democratic members of Congress of discouraging their constituents from signing up for the drug benefit for political motivations.

Liberal interest groups have supplemented Democratic efforts. MoveOn has made the negotiation issue part of its "caught red handed" series of ads which is aimed at four House Republican incumbents, including Rep. Nancy Johnson, R-Conn., who played a key role in drafting the drug law. Two liberal advocacy groups -- Campaign for America's Future and Americans United -- plan to hold events around the country to influence '06 races on this issue.

Charging that some large employers like Wal-Mart are "shirking their responsibilities" by not providing health insurance, the AFL-CIO backed "fair share" health care legislation in 31 states earlier this year.

"Fair share" legislation was dealt a setback in July when a federal judge overturned Maryland's "fair share" legislation on the basis that it violates the federal ERISA law. The Maryland law which was struck down would have required companies with 10,000 or more employees that pay less than eight percent of payroll expenses on health care to pay the state the difference. That money is put into a fund that expands Medicaid eligibility.

The "fair share" decision is currently on appeal.

Beyond these debates, there is no evidence at this point that health care will be a major part of the election dialogue this year. Democrats are wary of advocating expensive programs at a time when they are criticizing Republicans for deficit spending, and when they are trying to avoid the label of being a tax-and-spend party.