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Confident Democrats Draft Broad Health Care Agenda

By Robert Pear


Expecting to gain seats in Congress, Democrats are drafting an ambitious health care agenda to carry out their campaign promises with legislation to lower drug costs for older Americans, provide more money for children’s health insurance and expand research using embryonic stem cells.

Many Democrats in the House and the Senate say they want federal officials to negotiate directly with pharmaceutical companies to obtain lower prices for Medicare beneficiaries. The 2003 Medicare law explicitly prohibits such negotiations.

Rep. Nancy Pelosi of California, the House Democratic leader, said that if Democrats were in control, they would try to repeal that ban in the first 100 hours after the House convenes.

Private insurers already negotiate drug discounts for Medicare beneficiaries, but Democrats say the government could get a better deal.

“I don’t know that we could undo all the private plans,” said Rep. Pete Stark of California, who would be chairman of an important health subcommittee if Democrats were in the majority. “But at least we could offer a government-administered drug benefit. Under the existing program, we virtually guarantee the insurance companies against loss, which is a ludicrous position for us to be in.”

For 12 years, House Democrats have felt powerless to shape the health care agenda. Now they sense a major opportunity. Not only are they using health care as an issue in the midterm elections, but they also plan to use it to set the stage for the 2008 presidential campaign.

Chris Murphy, the Democrat challenging Rep. Nancy L. Johnson in Connecticut, has attacked her role in writing the 2003 Medicare law, while Johnson takes credit for helping “millions of seniors.”

In Ohio, the Democratic candidate for the Senate, Rep. Sherrod Brown, repeatedly points out that the number of uninsured has increased by more than five million since President Bush took office.

Embryonic stem cell research has been a defining issue in Senate races in Arizona, Maryland and Minnesota. Republicans are not ceding those issues to Democrats.

In a recent television commercial, Rep. John E. Sweeney, a four-term Republican from upstate New York, boasts that he has “come through for every hospital in this part of New York — every one.” Sen. Lincoln Chafee, Republican of Rhode Island, and Rep. Deborah Pryce, Republican of Ohio, boast that they split with Bush and voted for research using embryonic stem cells.

On Capitol Hill, the Democratic agenda faces three significant constraints: Bush, fiscal reality and industry resistance.

Any move to allow direct federal negotiation of drug prices would be opposed by the White House, most congressional Republicans and drug companies, which stand to lose more than any other industry if Democrats take control of Congress.

Drug companies worked closely with Republicans to pass the 2003 Medicare law, and drug makers have overwhelmingly favored Republicans over Democrats in their campaign contributions.