A top Medicare official told Congress Wednesday he had considered quitting to protest what he called an unethical Bush administration effort to stop him from telling lawmakers the cost of Medicare legislation.
Medicare actuary Richard Foster told the House Ways and Means Committee that he stayed to fight what he called “inappropriate” decisions to keep Congress from finding out his cost estimates were more than $100 million higher than theirs.
Foster’s testimony came as Democrats asked the Justice Department to investigate whether he was threatened with firing last summer if he gave Congress his estimates of the cost of Medicare’s new prescription drug benefit.
Foster has complained that Thomas Scully, who ran the Medicare agency until December and is now a lobbyist, stopped him from telling lawmakers about his higher estimates of the legislation’s cost.
The Associated Press, quoting several officials, reported last June that Scully had threatened to fire Foster. At the time, Scully characterized his remarks as “heated rhetoric in the middle of the night.”
Political decision?
Foster said he told Scully, as well as officials at the White House and the Health and Human Services Department, that “there’s been a longstanding practice to have the actuary give technical assistance to Congress if asked.”
But Foster said Scully ordered him not to respond to the Democrats’ request. Instead, congressional inquiries would go to Scully, who would decide whether to respond.
“What I perceived was that some responses went out and some responses did not go out, and it struck me as a political basis for making that decision,” Foster said. “I considered that inappropriate and, in fact, unethical.”
After a lawyer told him Scully did have the legal right to tell him not to give Congress the information, Foster said he had three choices: give Congress the information and be fired, quit and go public or follow orders and do nothing.
After discussing it with his staff, he decided to stay. “I would be better off working in the system,” said Foster, who noted that he now has assurances from HHS Secretary Tommy Thompson and Scully’s successor, Mark McClellan, that he can respond to congressional requests.
A telephone message left for Scully was not immediately returned.
Democrats allege 'potential violations'
HHS began an investigation last week. Democrats have requested a review by the General Accounting Office, the investigative arm of Congress.
Four Democratic senators, in a letter to Attorney General John Ashcroft, said the instructions that Foster says he received could constitute criminal violations.
“These potential violations” by the department, the White House budget office and the White House “are a serious matter that must be investigated,” wrote Sens. Debbie Stabenow of Michigan, Frank Lautenberg of New Jersey, Edward Kennedy of Massachusetts and Hillary Clinton of New York.
Since President Bush signed the prescription drug bill in December, the administration has acknowledged it believes the law will cost $534 billion over 10 years. That compares with $395 billion estimated by congressional budget analysts.
Keeping the bill’s cost below $400 billion was considered critical to winning enough votes of conservative Republicans so the bill could pass in the House.
Democrats, GOP differ
Treasury Secretary John Snow told the committee Wednesday that he knew nothing about the differing estimates. “I didn’t become aware of that until sometime in January when we began to put the president’s budget to bed,” Snow said.
House Democrats said the administration purposely kept Congress in the dark to ensure they got the votes for their bill.
Republicans countered that all of the 10-year cost estimates made so far may prove to be wrong. “All of us know that no one has the right answer,” said the committee chairman, Rep. Bill Thomas, R-Calif. “Time will likely show that both estimates are wrong.”
On Tuesday, Snow and the Medicare program’s other trustees reported that primary hospital care trust fund will be insolvent by 2019 without changes. That is 11 years sooner than the trustees had projected just two years ago.