Has Bush's Medicare Plan Got A Chance?

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During the State of the Union speech, congressional Republicans applauded President Bush's plan to pass a $400 billion Medicare reform package before 2004. But some Republicans on Capitol Hill who have fought and lost many Medicare battles fear the White House is too distracted by Iraq and the economy to deliver on an issue dear to their constituents. They say they are concerned they will be stuck defending a plan they don't fully support, without even the help of the President's megaphone. "I'm worried that once the war begins we're going to be on our own," said an influential House Republican. Sources familiar with the package say it will find savings by enticing seniors into managed care with the promise of prescription drugs. But those who remain in the existing fee-for-service program could find themselves shut out of the new drug benefit. The idea of forcing seniors into managed care as the price of obtaining drug coverage looks like political suicide to lawmakers of both parties, who for years have been promising seniors a comprehensive solution to the rising costs of prescriptions. It could be a deal-breaker, warns Finance Committee chairman Charles Grassley, the Iowa Republican whose panel will shepherd the legislation through the Senate. The White House dismisses fears it won't be fully engaged; in the meantime, even G.O.P. health-care experts who advise Bush are skeptical that his proposal will get anywhere. Said one: "It's never going to happen." --By John F. Dickerson and Karen Tumulty