GovernmentExecutive.com

Contradicting widespread expectations, the White House Wednesday said that under President Bush's forthcoming Medicare reform proposal, seniors can remain in the traditional fee-for-service plan and still have access to prescription drugs.

But the amount by which the drug benefit would be subsidized - or even the extent that it will be a new benefit at all - remained unclear. "Under the president's proposal, under Medicare, you will be in Medicare and you will have access to prescription drugs through a fee-for-service program," White House Press Secretary Ari Fleischer said Wednesday.

But, asked if seniors would have to pay extra for the benefit under fee-for-service, Fleischer said: "The cost benefit will be very parallel to what you see today, where seniors pay for prescription drugs." But he added, "of course, all seniors, under the president's proposal, will have government help, will have a government subsidy."

The comments came in the wake of news reports last week that seniors would have to enlist in managed care to receive a prescription drug benefit. Fleischer today labeled "categorically" wrong any report that asserted "the only way to get prescription drugs is to join an HMO." Fleischer compared the president's proposal, which he said had still not been finished, to the Federal Employee Health Benefits Program. Fleischer described the FEHBP as "series of options and choices" that includes fee-for-service, managed care, and PPOs.

On Capitol Hill Wednesday, House Majority Leader Tom DeLay, R-Texas, also rejected the characterization that Bush's proposed Medicare prescription drug program would force seniors into HMOs, saying it is premature to speculate on how the program might work. "We're in the process of discussing what the plan is," DeLay said.

DeLay noted the House has twice passed a prescription drug bill, but declined to comment on whether Bush's proposal would be similar to previous House-passed bills. DeLay blamed Senate Democrats for holding up previous passage, and said his party wants to pass legislation into law. "We expect to do it again," DeLay said. "This time we have a Republican Senate and a president that wants to sign it."

Bush, meanwhile, barely touched on the issue during a speech Wednesday in Grand Rapids, Mich., that the White House had billed as an address focusing on Medicare reform. He compared his plan to the FEHBP and said it would cost $400 billion over 10 years, as he indicated in Tuesday evening's State of the Union speech.

Much of the rest of Bush's remarks also tracked the State of the Union, as he began with an outline of his domestic proposals and moved into a discussion of terrorism and Iraq.