House Rejects Impotence Coverage

House Rejects Coverage of Impotence Pills


By SHERYL GAY STOLBERG
Published: June 25, 2005
WASHINGTON, June 24 - By a two-to-one margin, the House voted Friday to bar Medicaid and Medicare, the government insurance programs for the poor and elderly, from paying for Viagra and other medicines that treat sexual impotence in men.


Forum: The 109th Congress
Medicaid currently spends about $15 million a year on impotence drugs, proponents of the measure said. But they cited Congressional Budget Office projections saying the government would spend $2 billion over 10 years on impotence treatments once Medicare began offering prescription drug coverage in 2006.

"We provide drugs through Medicare and Medicaid that are lifesaving drugs; we don't pay for lifestyle drugs," said Representative Steve King, Republican of Iowa, the chief sponsor of the measure.

Mr. King said it was wrong to tell taxpayers that "we're going to take the money you earned on overtime to pay for Grandpa's Viagra."

Mr. King's amendment names Viagra and the two other medicines, Cialis and Levitra, approved by the Food and Drug Administration to treat impotence, which can occur as a side effect of depression or illness. It would still have to pass in the Senate, where Senator Charles E. Grassley, the Iowa Republican who is the chairman of the committee that oversees Medicare and Medicaid, has introduced a similar measure.

Opponents, including the pharmaceutical industry, said they would work to keep the King amendment out of the Senate counterpart of the House health and education spending bill. A drug industry spokesman estimated that hundreds of thousands of men would be affected by the ban.

"It's a terrible precedent, to knock out a whole class of drugs from a formulary," Representative Nancy L. Johnson, Republican of Connecticut, said. "Is the next round going to be hormones for women?"

Impotence drugs have become huge sellers for the pharmaceutical industry since Viagra, marketed by Pfizer, was introduced in 1998. The Pharmaceutical Research and Manufacturers of America, the trade group, which appeared to be caught off guard by Friday's vote, denounced the measure, saying the drugs are legitimate treatments for men who experience impotence as a result of prostate cancer surgery, diabetes, depression and other medical disorders.

"Unfortunately, the House is telling these men, 'Tough luck, you're on your own,' " said Ken Johnson, a senior vice president of the trade group. "Hopefully, the Senate will view this important health issue with a little more compassion."

In passing the House bill, 100 Democrats joined with 185 Republicans to approve the measure, by a final vote of 285 to 121. It was tacked onto a far-reaching spending bill providing more than $600 billion for a wide array of health and education programs, including money for the National Institutes of Health, student loans and programs to combat AIDS.

The vote came amid a national furor over a recent report that found scores of rapists and convicted sex offenders had been receiving Viagra and other impotence drugs through Medicaid. Last month, the federal government informed states that they could not use Medicaid money to provide the drugs to convicted sex offenders, and the bill the House passed on Friday included a provision to that effect.

The amendment to ban impotence drugs for all recipients of Medicaid and Medicare generated little debate, as lawmakers hurried to vote on many other amendments to the spending bill. Afterward, some who backed Mr. King's provision shied away from discussing their reasons.

"The amendment just came up, and that was that," said Representative Ralph Regula, Republican of Ohio, who is the chairman of the appropriations subcommittee that governs Medicaid and Medicare spending, and who voted for the amendment.

"There wasn't much of an opportunity to hear the medical merits of this," Mr. Regula said.

Opponents complained afterward that the House was treading on dangerous turf by making medical judgments that could affect Americans' most intimate moments.

"There is a value for Congress not to dictate to people what is important in their own lives," said Representative Jay Inslee, Democrat of Washington.

Mr. Inslee likened banning payment for impotence drugs to barring arthritis medicines that might help older people continue to play golf or the piano.

"If we have medicine that allow Americans to engage in activities such as golf and piano," he said, "what is the reason, other than some sort of embarrassment factor, residual from our youth, that makes this less important?"

But Mr. King said a better comparison would be fertility treatments, which Medicaid does not cover. "I argue that sex has only two reasons, one of them is for procreation, and we don't subsidize procreation in the form of fertility drugs," he said. "And the other reason for sex is recreation, and we should not be funding recreational drugs of any kind, be they psychedelic or for sexual impotency."

 

makes sense...we don't need publically sponsered population boosting