WASHINGTON – The nation’s top Medicare cost analyst confirmed yesterday that his former boss had ordered him to withhold from lawmakers unfavorable cost estimates about the Medicare prescription-drug bill. He said the estimates exceeded what Congress seemed willing to accept by more than $100 billion.
Richard Foster, chief actuary at the Centers for Medicare & Medicaid Services, said that in early June he received a written note from Thomas Scully, then the centers’ administrator, ordering him to ignore information requests from members of Congress who were drafting the drug bill.
The Inquirer Washington Bureau reported the episode in an exclusive published yesterday, but Foster’s comments were his first on the matter. Yesterday, House and Senate leaders called for investigations into the alleged muzzling. Senate Minority Leader Tom Daschle (D., S.D.) said the allegations justified reopening the vote on the drug benefit. Sen. Edward M. Kennedy (D., Mass.) wrote President Bush demanding to know what cost estimates he used in pushing the new drug benefit, which Congress passed in November and which Bush signed into law Dec. 8.
Scully’s note, Foster said, “was a direct order not to respond to certain requests and instead to provide the responses to him and warn about the consequences of insubordination.”
The note was Scully’s first threat in writing, according to Foster, and came after at least three less formal threats.
They “came in different forms,” he said. “Sometimes he would make a comment that ‘I think I need another chief actuary,’ or, ‘If you want to work for the Ways and Means Committee, I can arrange it.’ It was that sort of thing.” Ways and Means was drafting the bill.
Efforts to reach Scully at his office and home yesterday were unsuccessful. In a recent interview, he denied closing off Foster’s lines of communication with Congress. On only one occasion, Scully said, did he block Foster’s contacts with lawmakers, in this case Democrats, saying their motives were purely political.
Foster said Scully insisted on a pattern of withholding of information.
“Estimates that were supportive of the legislation were generally released, and estimates that could be used to criticize the legislation were generally not released,” Foster said.
He said he believed that higher-ranking members of the administration than Scully knew of the higher cost estimates his office had computed.
“Did the President know? Did Secretary Tommy Thompson know? I don’t know,” Foster said. Thompson heads the Department of Health and Human Services, which oversees the Medicare office.
The White House press office did not respond to requests seeking comment.
The Inquirer reported yesterday that Foster’s office had suggested that the drug benefit would cost at least $100 billion more than the $395 billion estimated by the Congressional Budget Office, whose job it is to project costs of legislation.
One projection prepared in early June by Foster’s office and obtained by the Inquirer Washington Bureau concluded that a Senate version of the bill might cost as much as $551 billion.
At the time of the estimate, the House was sharply divided on the proposed new Medicare drug benefit, which the administration strongly backed. Ultimately, the House passed the measure, 216-215, on June 27. In November, it endorsed a House-Senate compromise version, 220-215; the yes votes included 13 Republican fiscal conservatives who had said they would vote against the bill if it cost more than $400 billion for its first 10 years.
When Bush signed the bill, the drug benefit was touted as costing $395 billion. In January, Bush’s budget director, Joshua Bolten, raised the estimate to $534 billion.
Senate Majority Leader Bill Frist (R., Tenn.) noted yesterday that Foster’s estimates were based on different and costlier assumptions than those of the Congressional Budget Office.
Frist spokesman Bob Stevenson added: “If an individual’s job was threatened and if they were trying to shield information from Congress, that could be an issue of concern.”
Sen. Charles E. Grassley (R., Iowa), chairman of the Finance Committee, said Foster’s estimates “should not have been withheld. Government analysts with relevant information should never be muzzled.”
In a floor speech yesterday, Daschle called for reopening the vote on the drug benefit. He also called for an investigation into the firing threat and assertions that the administration had withheld its cost estimates from Congress.
“Whether this is criminal or not is a matter we will certainly want to clarify,” Daschle said. “But if not criminal, it was certainly unethical. And I think we need to know the facts.”
A group of House Democrats concurred, asking that the HHS inspector general investigate.
Foster, a senior civil servant, remains on his job. He said he had new and strong support from Thompson and from Medicare’s newly confirmed chief, Mark McClellan.