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Analyst links Bush aide to hold on Medicare data
by Amy Goldstein
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Richard Foster, the government's chief analyst of Medicare costs, said last night he believes the White House participated in a decision to withhold analyses that Medicare legislation President Bush sought would be far more expensive than lawmakers knew.

In recent days, Foster has said publicly he was warned repeatedly by his former boss he would be fired if he replied directly to legislative requests for information about pending prescription-drug bills.

In an interview last night, he went further, saying he understood former Medicare administrator Thomas Scully to be acting at times on White House instructions, probably coming from Bush's senior health-policy adviser.

Foster said he did not have concrete proof of a White House role, but that his inference was based on the nature of several conversations he had with Scully over data Congress had requested and that Foster wanted to release. "I just remember Tom being upset, saying he was caught in the middle. It was like he was getting dumped on," Foster said.

Foster added he believed, but did not know for certain, that Scully had been referring to Doug Badger, the senior health-policy analyst.

He said Badger was the White House official most steeped in the administration's negotiations with Congress over Medicare legislation enacted last year and was intimately familiar with the analyses Foster's office produced.

The account by Foster, a longtime civil servant who has been the Medicare program's chief actuary for nine years, diverges sharply from explanations this week by White House spokesmen and Health and Human Services Secretary Tommy Thompson of why cost estimates were withheld.

Those explanations have suggested Scully, who left for jobs with law and investment firms four months ago, acted unilaterally and that he was chastised by superiors when they learned of the blocked information and the threat.

Thompson on Tuesday told reporters: "Tom Scully was running this. Tom Scully was making those decisions."

Thompson said the administration did not have final cost estimates until late December predicting the law would cost $534 billion over 10 years, $139 billion more than the Congressional Budget Office forecast. Foster has said his analyses as early as last spring showed the legislation would exceed $500 billion.

Trent Duffy, White House deputy press secretary, said last night Badger was traveling and unreachable for comment. Calls to his home were not returned.

Duffy, however, said he doubted Badger was involved.

"It is my understanding that Mr. Badger did not in any way ask anyone to withhold information from Congress or pressure anyone to do the same," said the White House spokesman, who added he had asked Badger this week whether he had done so, and the reply was no.

Meanwhile, new details emerged yesterday on the threats to Foster. The actuary released an e-mail, dated June 20, from Scully's top assistant regarding one GOP request and two Democratic requests for information about the impact of provisions of the Medicare bill on which the House would vote one week later.

In a bold-faced section of the three-paragraph note — reported in yesterday's Wall Street Journal — Scully's assistant, Jeffrey Flick, instructed Foster to answer the Republican's question but warned him not to disclose answers to the Democratic queries "with anyone else until Tom Scully explicitly talks with you — authorizing release of information. The consequences for insubordination are extremely severe."

The warning came in response to an e-mail Foster had sent to Scully that same Friday afternoon, 22 minutes earlier, in which he said the three questions "strike me as straightforward requests for technical information that would be useful in assessing drug and competition provisions in the House reform package."

Foster offered in that e-mail to show Scully his proposed replies in advance.

Flick, who now oversees the Medicare agency's regional office in San Francisco, did not return several phone calls.

Scully was out of town and did not respond to efforts to reach him via e-mail last night. He said in an interview this week he and Foster had disagreed over how helpful an executive-branch employee needed to be to Congress. He called it "a separation-of-powers issue."

Foster said the e-mail was the only instance in which he had been explicitly threatened in writing, but that "there were other instances in which Tom in an e-mail or just over the phone would clearly be unhappy and would say less formally something to the effect, 'If you want to work for the Ways and Means Committee, I can arrange that.' "

The actuary said that in June 2001, shortly after Scully arrived, he directed Foster to send weekly reports of any requests for information he had received from Capitol Hill or elsewhere in the administration.

Congressional Democrats yesterday called for the General Accounting Office to investigate the episode.

Thompson announced Tuesday he had ordered HHS's inspector general to conduct an inquiry.

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