Medicare reform bill carried in US House, veto or filibuster expected

The US House of Representatives has carried, by 225 votes to 170, HR 4, the Democratic Party's proposal to reform the Medicare Part D prescription drug benefit (Marketletters passim). The majority failed, by some distance, to reach the 290 votes necessary for a two-thirds majority. Without it and a similar "supermajority" in the Senate, President George W Bush will have the option of vetoing the Bill.

The Bill would require the Department of Health and Human Services to "negotiate discounts" or fix reference prices, according to critics, with the drug industry. The Bill is opposed by the federal administration, which argues that such negotiations could only work at the expense of the availability of some drugs, and that pharmacy benefit managers are already performing ahead of expectations at controlling drug costs.

Filibuster or veto?