The House Republican plan envisions a large role for companies that now manage pharmaceutical benefits for many working families with private insurance.

The revenues of the pharmaceutical benefit companies' "are going up at the same rate," he said.

After that, Mr. Bush said, Medicare would be transformed into a program of competing health plans, each of which must offer pharmaceutical benefits.

One percent of adults ages 20 to 64 now take the drugs, according to Medco, which administers pharmaceutical benefits for managed care companies.

The State finances, through general taxes, all health benefits and a percentage of pharmaceutical benefits.

The potential pharmaceutical benefits are enormous, and special biomaterials like spider silk may be the next big thing.

Under the Hagel-Ensign proposal, the federal government would have endorsed drug discount cards issued by private entities, including companies that manage pharmaceutical benefits for large employers.

While many industries face rising costs for pharmaceutical benefits, the auto makers said they had particularly acute problems.

G.M. is the nation's largest corporate provider of pharmaceutical benefits, covering 1.5 million employees and retirees along with their spouses and dependents.

"Democrats have a bumper sticker, 'Vote Democratic for pharmaceutical benefits,' and that's too powerful an argument for us not to do anything."