The Old and Poor Watch Out! The White House Won't Release Medicare Memo.

The Bush administration's top Medicare accountant has calculated how millions of senior citizens would be affected by bringing private managed care into the program, but the administration won't release the information.

An earlier analysis suggested that a Republican plan to inject market forces into Medicare could increase premiums for those who stay in traditional programs by as much as 25 percent. If that's still the case, it could help Democrats who argue that the GOP plan is risky for those who want to stay in traditional Medicare, where they can pick any doctor, rather than move to a managed care plan.

The administration's Medicare chief threatened to fire his top actuary, Rick Foster, if Foster released his calculations to Capitol Hill Democrats who requested the analysis, officials said.

Medicare chief Tom Scully said in an interview Wednesday that Democrats had no right to request the information from Foster in the first place.

"They don't have the right on the Hill to call up my actuary and demand things," said Scully, chief of the Centers for Medicare and Medicaid Services. "These people work for the executive branch, period."

Scully said he would release the analysis "if I feel like it."

Medicare spokesman Peter Ashkenaz said Foster is working to update his original memo based on changes being considered by House Republicans so the original version is not relevant.

Scully added that Democrats want the memo in hopes of scoring political points, as Congress debates legislation adding prescription drugs to Medicare and making other changes to the program.

"We're at the end of the Medicare debate," Scully said. "People are looking for bombs to throw."

Officials on Capitol Hill and at the Department of Health and Human Services said Scully threatened to fire Foster if he released his memo. Scully said that was an exaggeration, saying his comments were just "heated rhetoric in middle of the night."

Democrats responded by pointing to legislative language approved in 1997 that specifically requires the top Medicare actuary to answer questions from Congress.

"While the chief actuary is an official within the administration, this individual and his or her office often must work with the committees of jurisdiction in the development of legislation," said the legislative report.

Democrats suspect the information is being withheld because it will undercut the administration's case for changes to Medicare. Democrats object to a proposal that would set premiums for seniors through competition between private plans and the traditional, government-run program.

Republicans believe it will drive down Medicare spending by directing more seniors to cost-effective plans. Democrats worry that the sickest seniors will wind up in the government-run program, paying more for health coverage than they do today.

"The administration is resisting the release of it because it's not good news for the Republican House plan," said House Minority Leader Nancy Pelosi, D-Calif.

The earlier Foster memo, written in 2000, found that a similar proposal would boost premiums for traditional Medicare by 47 percent. But nearly half the increase was attributable to a provision that is no longer on the table. The provision now being considered would increase premiums by 25 percent, Foster said in 2000. Democrats asked for an updated estimate.

Scully has repeatedly touted Foster and his colleagues as the best actuaries anywhere. Just last week, in defending a separate Foster analysis that supports the administration's position, Scully noted that Foster has worked for both Democrats and Republicans and is a professional actuary totally divorced from politics.


Copyright © 2003, The Associated Press.