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139-467: The task force was formed during the Presidency of George W. Bush to investigate hardcore pornography at the urging of social conservative groups. Notable cases were brought against Joseph R. Francis ' Mantra Films, Inc. ( Girls Gone Wild ), as well as producers Ira Isaacs , John Stagliano , and Max Hardcore . Eric Holder , Barack Obama 's appointee for United States Attorney General , dissolved

278-454: A Republican from Texas , took office following his narrow electoral college victory over Democratic incumbent vice president Al Gore in the 2000 presidential election , in which he lost the popular vote to Gore by 543,895 votes. Four years later, in the 2004 presidential election , he narrowly defeated Democrat nominee John Kerry , to win re-election and winning both the popular and the electoral college vote. Bush served two terms and

417-507: A simultaneous air and land attack on Iraq on March 20, 2003, in what the American media called " shock and awe ." With 145,000 soldiers, the ground force quickly overcame most Iraqi resistance, and thousands of Iraqi soldiers deserted. The U.S. captured the Iraqi capital of Baghdad on April 9, but Hussein escaped and went into hiding. While the U.S. and its allies quickly achieved military success,

556-698: A $ 1.3 trillion tax cut program and the No Child Left Behind Act , a major education bill. He also pushed for socially conservative efforts, such as the Partial-Birth Abortion Ban Act and faith-based welfare initiatives . Also in 2003, he signed the Medicare Prescription Drug, Improvement, and Modernization Act , which created Medicare Part D . During his second term, Bush reached multiple free trade agreements and successfully nominated John Roberts and Samuel Alito to

695-626: A 58–42 vote in January 2006. In the years immediately after Roberts and Alito took office, the Roberts Court was generally more conservative than the preceding Rehnquist Court , largely because Alito tended to be more conservative than O'Connor had been. Bush also appointed 62 judges to the United States Courts of Appeals , 261 judges to the United States district courts , and 2 judges to

834-417: A geographic area. The tool lets users input their own list of medications and then calculates personalized projections of the enrollee's annual costs under each plan option. Plans are required to submit biweekly data updates that Medicare uses to keep this tool updated throughout the year. Part D includes a statutorily defined "standard benefit" that is updated on an annual basis. All Part D sponsors must offer

973-531: A judge, but who had worked as a corporate lawyer and White House staffer. Her nomination immediately faced opposition from conservatives (and liberals) who were wary of her unproven ideology and lack of judicial experience. After Senate Majority Leader Bill Frist informed Bush that Miers did not have the votes necessary to win confirmation, Miers withdrew from consideration. Bush then nominated Samuel Alito , who received strong support from conservatives but faced opposition from Democrats. Alito won confirmation in

1112-401: A lack of public support. In the decades following Medicare's passage, prescription drug spending grew and became increasingly financed through third-party payment. Following an era of modest growth, per capita drug spending began growing rapidly in the 1980s. This growth was partially spurred by the launch of many billion dollar “blockbuster drugs” like Lipitor , Celebrex , and Zoloft . At

1251-798: A major economic disaster, and he established the Troubled Asset Relief Program (TARP) to buy toxic assets from financial institutions. At various points in his presidency, Bush was among both the most popular and unpopular presidents in U.S. history. He received the highest recorded approval ratings in the wake of the September 11 attacks, but also one of the lowest such ratings during the Iraq War and 2007–2008 financial crisis. Although public sentiment of Bush has improved since he left office, his presidency has generally been rated as below-average by scholars. The oldest son of George H. W. Bush ,

1390-544: A modest deductible , beneficiaries would pay 25% cost-sharing for covered drugs. However, once their spending reached an “initial coverage limit,” originally set at $ 2,250, their cost-sharing would return to 100% of the drug's cost. This loss in coverage would continue until the patient surpassed an out-of-pocket threshold Beneficiaries were often confused by this complicated design, and research consistently found that this coverage gap reduced medication adherence . The Affordable Care Act and subsequent legislation phased-out

1529-518: A partial manual recount, but the United States Supreme Court effectively ordered an end to this process, on equal protection grounds, in the case of Bush v. Gore , leaving Bush with a victory in both the state and the election. Bush won the presidential election with 271 electoral votes compared to Gore's 266, though Gore narrowly won a plurality of the nationwide popular vote, receiving 543,895 more votes than Bush. Bush thus became

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1668-424: A plan that follows the standard benefit. The standard benefit is defined in terms of the benefit structure and without mandating the drugs that must be covered. For example, under the 2020 standard benefit, beneficiaries first pay a 100% coinsurance amount up to a $ 435 deductible. Second, beneficiaries pay a 25% coinsurance amount up to an Out-of-Pocket Threshold of $ 6,350. In the final benefit phase, beneficiaries pay

1807-549: A plan with cost-sharing that is lower than the standard benefit, and this additional amount is not Federally-subsidized. Prior to 2010, the standard benefit included a Coverage Gap phase in which, after accruing significant spending, relatively-high cost enrollees were required to pay a 100% coinsurance amount until they entered the Catastrophic phase. This Coverage Gap phase is commonly referred to as "the Donut Hole." Beginning with

1946-447: A program that provides financial assistance to employers who offer prescription drug coverage to their retirees. The subsidy is a feature of Medicare Part D, designed to help retirees access affordable prescription medications. Beneficiaries with income below 150% of the poverty line are eligible for the low-income subsidy, which helps pay for premiums and cost-sharing. Depending on income-level and assets, some beneficiaries qualify for

2085-539: A resolution called the Authorization for Use of Military Force Against Terrorists , authorizing the president to use the military against those responsible for the attacks. On October 7, 2001, Bush ordered the invasion of Afghanistan . General Tommy Franks , the commander of the United States Central Command (CENTCOM), drew up a four-phase invasion plan. In the first phase, the U.S. built up forces in

2224-605: A sharp reduction in the number of people over the age of 65 who worked full-time. The authors say that this is evidence that before the change, people avoided retiring in order to maintain employer-based health insurance. The federal government is not permitted to negotiate Part D drug prices with drug companies, as federal agencies do in other programs. Numerous critics view this as a mismanagement of taxpayer funds, whereas proponents contend that allowing price negotiation might inhibit innovation by reducing profits for pharmaceutical companies. The Department of Veterans Affairs , which

2363-557: A shift in U.S. public opinion towards support of the war, it failed to convince the French, Russians, or Germans. Contrary to the findings of Blix and ElBaradei, Bush asserted in a March 17 public address that there was "no doubt" that the Iraqi regime possessed weapons of mass destruction. Two days later, Bush authorized Operation Iraqi Freedom , and the Iraq War began on March 20, 2003. U.S.-led coalition forces, led by General Franks, launched

2502-545: A spirited challenge that was supported by many moderates and foreign policy hawks . McCain's loss in the South Carolina primary effectively ended the 2000 Republican primaries , and Bush was officially nominated for president at the 2000 Republican National Convention . Bush selected former secretary of defense Dick Cheney as his running mate; though Cheney offered little electoral appeal and had health problems, Bush believed that Cheney's extensive experience would make him

2641-545: A stand-alone prescription drug plan or through a Medicare Advantage plan that includes prescription drug benefits. Beneficiaries can enroll directly through the plan's sponsor or through an intermediary. Medicare beneficiaries who delay enrollment into Part D may be required to pay a late-enrollment penalty. In 2019, 47 million beneficiaries were enrolled in Part D, which represents three-quarters of Medicare beneficiaries. Part D benefits are provided through private plans approved by

2780-502: A struggle between the terrorists and the aircraft's passengers. The attacks had a profound effect on many Americans, who felt vulnerable to international attacks for the first time since the end of the Cold War . Appearing on national television on the night of the attacks, Bush promised to punish those who had aided the attacks, stating, "we will make no distinction between the terrorists who committed these acts and those who harbor them." In

2919-469: A terrorist campaign against U.S. targets, orchestrating attacks such as the 1998 United States embassy bombings and the 2000 USS Cole bombing . During Bush's first months in office, U.S. intelligence organizations intercepted communications indicating that al-Qaeda was planning another attack on the United States, but foreign policy officials were unprepared for a major attack on the United States. Bush

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3058-530: A valuable governing partner. With Democratic President Bill Clinton term-limited, the Democrats nominated Vice President Al Gore of Tennessee for president and Senator Joe Lieberman of Connecticut for vice president. Bush's campaign emphasized their own candidate's character in contrast with that of Clinton, who had been embroiled in the Lewinsky scandal . Bush held a substantial lead in several polls taken after

3197-595: A year). Economist Joseph Stiglitz in his book entitled The Price of Inequality estimated a "middle-cost scenario" of $ 563 billion in savings "for the same budget window". Former Congressman Billy Tauzin , R–La., who steered the bill through the House, retired soon after and took a $ 2 million a year job as president of Pharmaceutical Research and Manufacturers of America (PhRMA), the main industry lobbying group. Medicare boss Thomas Scully , who threatened to fire Medicare Chief Actuary Richard Foster if he reported how much

3336-470: Is 706 percent more expensive than the VA price for brand-name Zocor. The lowest price for sertraline HCl (generic Zoloft) is 47 percent more expensive than the VA price for brand-name Zoloft." Estimating how much money could be saved if Medicare had been allowed to negotiate drug prices, economist Dean Baker gives a "most conservative high-cost scenario" of $ 332 billion between 2006 and 2013 (approximately $ 50 billion

3475-413: Is allowed to negotiate drug prices and establish a formulary, has been estimated to pay between 40% and 58% less for drugs, on average, than Part D. On the other hand, the VA only covers about half the brands that a typical Part D plan covers. Part of the issue is that Medicare does not pay for Part D drugs, and so has no actual leverage. Part D drug providers are using the private insurer leverage, which

3614-495: Is associated with a set co-pay amount. Most formularies have between 3 and 5 tiers. The lower the tier, the lower the co-pay. For example, Tier 1 might include all of the Plan's preferred generic drugs, and each drug within this tier might have a co-pay of $ 5 to $ 10 per prescription. Tier 2 might include the Plan's preferred brand drugs with a co-pay of $ 40 to $ 50, while Tier 3 may be reserved for non-preferred brand drugs which are covered by

3753-520: Is generally a larger block of consumers than the 40 million or so actually using Medicare parts A and B for medical care. Although generic versions of [frequently prescribed to the elderly] drugs are now available, plans offered by three of the five [exemplar Medicare Part D] insurers currently exclude some or all of these drugs from their formularies. ... Further, prices for the generic versions are not substantially lower than their brand-name equivalents. The lowest price for simvastatin (generic Zocor) 20 mg

3892-817: The Affordable Care Act , cost-sharing in the Coverage Gap phase has been gradually reduced. Despite no longer triggering elevated cost-sharing, the Coverage Gap phase continues to exist for other administrative purposes. In 2020, the average monthly Part D premium across all plans was $ 27. Premiums for stand-alone PDPs are 3 times higher than premiums for MA-PDs, as Medicare Advantage plans often use federal rebates to reduce premiums for drug coverage. Enrollees typically pay their premiums directly to plans, though they may opt to have their premiums automatically deducted from their Social Security checks. Plans offer competitive premiums to attract enrollees. Premiums must cover

4031-524: The Bill Clinton administration , and with the Federal Reserve chairman Alan Greenspan 's support, Bush argued that the best use of the surplus was to lower taxes. By the time Bush took office, reduced economic growth had led to less robust federal budgetary projections, but Bush maintained that tax cuts were necessary to boost economic growth. After Treasury secretary Paul O'Neill expressed concerns over

4170-507: The Bipartisan Campaign Reform Act , stating that he thought the law would improve the financing system for elections but was "far from perfect." The law placed several limits on political donations and expenditures, and closed loopholes on contribution limits on donations to political candidates by banning the use of so-called "soft money." Portions of the law restricting independent expenditures would later be struck down by

4309-553: The Comprehensive Immigration Reform Act of 2006 , which included many of the president's proposals, but the bill did not pass the House of Representatives. After Democrats took control of Congress in the 2006 mid-term elections, Bush worked with Ted Kennedy to re-introduce the bill as the Comprehensive Immigration Reform Act of 2007 . The bill received intense criticism from many conservatives, who had become more skeptical of immigration reform, and it failed to pass

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4448-903: The Enron scandal, Bush signed the Sarbanes–Oxley Act into law. The act expanded reporting requirements for public companies Shortly after the start of his second term, Bush signed the Class Action Fairness Act of 2005 , which had been a priority of his administration and part of his broader goal of instituting tort reform . The act was designed to remove most class action lawsuits from state courts to federal courts, which were regarded as less sympathetic to plaintiffs in class action suits. Bush endorsed civil rights and appointed blacks, women and gays to high positions. The premier cabinet position, Secretary of State, went to Colin Powell (2001–2005),

4587-479: The Food and Drug Administration , drugs not available by prescription for purchase in the United States, and drugs for which payments would be available under Part B. Part D coverage excludes drugs or classes of drugs that may be excluded from Medicaid coverage. These may include: While these drugs are excluded from basic Part D coverage, drug plans can include them as a supplemental benefit, provided they otherwise meet

4726-666: The Iraqi insurgency opposed to the continuing U.S. presence. Fearing the further deterioration of Iraq's security situation, General John Abizaid ordered the end of the planned drawdown of soldiers, leaving over 130,000 U.S. soldiers in Iraq. The U.S. captured Hussein on December 13, 2003, but the occupation force continued to suffer casualties. Between the start of the invasion and the end of 2003, 580 U.S. soldiers died, with two thirds of those casualties occurring after Bush's "Mission Accomplished" speech. After 2003, more and more Iraqis began to see

4865-511: The Jobs and Growth Tax Relief Reconciliation Act of 2003 , which cut taxes by another $ 350 billion over 10 years. That law also lowered the capital gains tax and taxes on dividends . Collectively, the Bush tax cuts reduced federal individual tax rates to their lowest level since World War II , and government revenue as a share of gross domestic product declined from 20.9% in 2000 to 16.3% in 2004. Most of

5004-987: The Kyoto Protocol , the Anti-Ballistic Missile Treaty , and the International Criminal Court . Terrorism had emerged as an important national security issue in the Clinton administration, and it became one of the dominant issues of the Bush administration. In the late 1980s, Osama bin Laden had established al-Qaeda , a militant Sunni Islamist multi-national organization that sought to overthrow Western-backed governments in Saudi Arabia , Jordan , Egypt , and Pakistan . In response to Saudi Arabia's decision to begin hosting U.S. soldiers in 1991, al-Qaeda had begun

5143-550: The OMB under Gerald Ford , was appointed secretary of the treasury, while former Missouri senator John Ashcroft was appointed attorney general. As Bush had little foreign policy experience, his appointments would serve an important role in shaping U.S. foreign policy during his tenure. Several of his initial top foreign policy appointees had served in his father's administration ; Vice President Cheney had been secretary of defense, National Security Adviser Condoleezza Rice had served on

5282-589: The Supreme Court . He sought major changes to Social Security and immigration laws, but both efforts failed. The wars in Afghanistan and Iraq continued, and in 2007 he launched a surge of troops in Iraq . The Bush administration's response to Hurricane Katrina and the dismissal of U.S. attorneys controversy came under attack, with a drop in his approval ratings. A global meltdown in financial markets dominated his last days in office as policymakers looked to avert

5421-565: The Taliban , destroy al-Qaeda , and capture Osama bin Laden . He also signed the controversial Patriot Act in order to authorize surveillance of suspected terrorists. In 2003, Bush ordered an invasion of Iraq , alleging that the Saddam Hussein regime possessed weapons of mass destruction . Intense criticism came when neither WMD stockpiles nor evidence of an operational relationship with al-Qaeda were found. Before 9/11, Bush had pushed through

5560-559: The Truman administration , Bush decided to use his newfound political capital to fundamentally change U.S. foreign policy. He became increasingly focused on the possibility of a hostile country providing weapons of mass destruction (WMDs) to terrorist organizations. During his early 2002 State of the Union Address , Bush set forth what has become known as the Bush Doctrine , which held that

5699-518: The U.S. Intelligence Community and expanded the government's domestic authority to conduct surveillance of suspected terrorists. The Patriot Act also authorized the use of roving wiretaps on suspected terrorists and expanded the government's authority to conduct surveillance of suspected " lone wolf " terrorists. Bush also secretly authorized the National Security Agency to conduct warrantless surveillance of communications in and out of

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5838-644: The United States Court of International Trade . Among them were two future Supreme Court associate justices: Neil Gorsuch to a seat on the Court of Appeals for the Tenth Circuit in 2006, and Brett Kavanaugh to the Court of Appeals District of Columbia Circuit in 2006. Bush's promise to cut taxes was the centerpiece of his 2000 presidential campaign, and upon taking office, he made tax cuts his first major legislative priority. A budget surplus had developed during

5977-570: The United States Supreme Court . Cheney and White House Counsel Harriet Miers selected two widely respected conservatives, D.C. Circuit Court of Appeals judge John Roberts and Fourth Circuit judge Michael Luttig , as the two finalists. In June 2005, Justice Sandra Day O'Connor unexpectedly announced that she would retire from the court, and Bush nominated Roberts for her position the following month. After Rehnquist died in September, Bush briefly considered elevating Associate Justice Antonin Scalia to

6116-613: The reconciliation , which in turn necessitated that the tax cuts would phase out in 2011 barring further legislative action. After the tax bill was passed, Senator Jim Jeffords left the Republican Party and began caucusing with the Democrats, giving them control of the Senate. After Republicans re-took control of the Senate during the 2002 mid-term elections, Bush proposed further tax cuts. With little support among Democrats, Congress passed

6255-400: The scientific consensus on climate change . Bush stated that he believed global warming is real and a serious problem, although he asserted that there existed a "debate over whether it's man-made or naturally caused". The Bush administration's stance on global warming remained controversial in the scientific and environmental communities. Critics alleged that the administration misinformed

6394-591: The $ 700 billion Troubled Asset Relief Program (TARP) to buy toxic assets . The House rejected TARP in a 228–205 vote; although support and opposition crossed party lines, only about one-third of the Republican caucus supported the bill. After the Dow Jones Industrial Average dropped 778 points on the day of the House vote, the House and Senate both passed TARP. Bush later extended TARP loans to U.S. automobile companies, which faced their own crisis due to

6533-464: The 1980s, a mixture of Democrats and Republicans defied Speaker Dennis Hastert and passed a campaign finance reform bill. The House approved the bill with a 240–189 vote, while the bill passed the Senate in a 60–40 vote, the bare minimum required to overcome the filibuster. Throughout the congressional battle on the bill, Bush declined to take a strong position. However, in March 2002, Bush signed into law

6672-402: The 1990s and 19% of the drugs approved since 2000 were on the formulary. In 2012, the plan required Medicare beneficiaries whose total drug costs reach $ 2,930 to pay 100% of prescription costs until $ 4,700 is spent out of pocket. (The actual threshold amounts change year-to-year and plan-by-plan, and many plans offered limited coverage during this phase.) While this coverage gap does not affect

6811-748: The 2000 election convinced many Republicans, including Congressman John Boehner of Ohio, to accept an education reform bill that increased federal funding. Seeking to craft a bipartisan bill, Bush courted Democratic senator Ted Kennedy , a leading liberal senator who served as the ranking member on the Senate Committee on Health, Education, and Pensions . Bush favored extensive testing to ensure that schools met uniform standards for skills such as reading and math. Bush hoped that testing would make schools more accountable for their performances and provide parents with more information in choosing which schools to send their children. Kennedy shared Bush's concern for

6950-427: The 2000 election, Bush established a stable of advisers, including supply-side economics advocate Lawrence B. Lindsey and foreign policy expert Condoleezza Rice . With a financial team led by Karl Rove and Ken Mehlman , Bush built up a commanding financial advantage over other prospective Republican candidates. Though several prominent Republicans declined to challenge Bush, Arizona senator John McCain launched

7089-467: The 41st president of the United States, George W. Bush emerged as a presidential contender in his own right with his victory in the 1994 Texas gubernatorial election . After winning re-election by a decisive margin in the 1998 Texas gubernatorial election , Bush became the widely acknowledged front-runner in the race for the Republican nomination in the 2000 presidential election . In the years preceding

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7228-504: The Ba'ath Party merely as a career move. Bremer's second major order disbanded the Iraqi military and police services, leaving over 600,000 Iraqi soldiers and government employees without jobs. Bremer also insisted that the CPA remain in control of Iraq until the country held elections, reversing an earlier plan to set up a transition government led by Iraqis. These decisions contributed to the beginning of

7367-583: The Bush administration arranged passage of the Economic Stimulus Act of 2008 . Falling home prices started threatening the financial viability of many institutions, leaving Bear Stearns , a prominent U.S.-based investment bank, on the brink of failure in March 2008. Recognizing the growing threat of a financial crisis, Bush allowed Treasury secretary Paulson to arrange for another bank, JPMorgan Chase , to take over most Bear Stearn's assets. Out of concern that Fannie Mae and Freddie Mac might also fail,

7506-423: The Bush administration put both institutions into conservatorship . Shortly afterwards, the administration learned that Lehman Brothers was on the verge of bankruptcy, but the administration ultimately declined to intervene on behalf of Lehman Brothers. Paulson hoped that the financial industry had shored itself up after the failure of Bear Stearns and that the failure of Lehman Brothers would not strongly impact

7645-542: The Bush tax cuts were later made permanent by the American Taxpayer Relief Act of 2012 , though that act rolled back the tax cuts on top earners. Contrary to the rhetoric of the Bush administration and Republicans, the budget deficit increased, leaving many to believe the tax cuts were at fault. Statements by President Bush, Vice President Dick Cheney , and Senate Majority Leader Bill Frist that these tax cuts effectively "paid for themselves" were disputed by

7784-639: The CBPP, the U.S. Treasury Department and the CBO. Aside from tax cuts, Bush's other major policy initiative upon taking office was education reform. Bush had a strong personal interest in reforming education, especially regarding the education of low-income and minority groups. He often derided the "soft bigotry of low expectations" for allowing low-income and minority groups to fall behind. Although many conservatives were reluctant to increase federal involvement in education, Bush's success in campaigning on education reform in

7923-779: The Catastrophic phase, the amount they have paid in cost-sharing is typically much less than the Out-of-Pocket Threshold. This is because the standard benefit requires plans to include additional amounts, such as manufacturer discounts, when determining if the Out-of-Pocket Threshold has been met. Part D sponsors may also offer plans that differ from the standard benefit, provided that these alternative benefit structures do not result in higher average cost-sharing. In practice, most enrollees do not elect for standard benefit plans, instead opting for plans without deductibles and with tiered drug co-payments rather than coinsurance. Enrollees must pay an additional premium amount to be enrolled in

8062-421: The Coverage Gap. Part D practices community rating , with all enrollees in a plan being assigned the same premium. Enrollees do pay more in premiums if they enroll in higher-than-average-cost plans or in plans that offer enhanced benefits. Like in Part B, higher-income enrollees are required to pay an additional premium amount. Low-income enrollees may have their premium reduced or eliminated if they qualify for

8201-548: The Gulf War; after the war, it had submitted to WMD inspections conducted by the United Nations Special Commission until 1998, when Hussein demanded that all UN inspectors leave Iraq. The administration believed that, by 2001, Iraq was developing weapons of mass destruction, and could possibly provide those weapons to terrorists. Some within the administration also believed that Iraq shared some responsibility for

8340-542: The Iraq War, contributing to a decline in Bush's approval ratings. Medicare Part D Medicare Part D , also called the Medicare prescription drug benefit , is an optional United States federal-government program to help Medicare beneficiaries pay for self-administered prescription drugs . Part D was enacted as part of the Medicare Modernization Act of 2003 and went into effect on January 1, 2006. Under

8479-545: The Medicare legislation included an outpatient drug benefit, those provisions were dropped due to budgetary concerns. In response to criticism regarding this omission, President Lyndon Johnson ordered the formation of the Task Force on Prescription Drugs . The Task Force conducted a comprehensive review of the American prescription drug market and reported that many elderly Americans struggled to afford their medications. Despite

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8618-524: The National Security Council, and deputy secretaries Paul Wolfowitz and Richard Armitage had also served in important roles. Secretary of State Colin Powell had served as chairman of the Joint Chiefs of Staff under the first president Bush. Bush had long admired Powell, and the former general was Bush's first choice for the position. Secretary of Defense Donald Rumsfeld , who had served in

8757-564: The Northern Alliance began its offensive on October 19. The capital of Kabul was captured on November 13, and Hamid Karzai was inaugurated as the new president of Afghanistan. However, the senior leadership of the Taliban and al-Qaeda, including bin Laden, avoided capture. Karzai would remain in power for the duration of Bush's presidency, but his effective control was limited to the area around Kabul, as various warlords took control of much of

8896-401: The Senate. After years of financial deregulation accelerating under the Bush administration, banks lent subprime mortgages to more and more home buyers, causing a housing bubble . Many of these banks also invested in credit default swaps and derivatives that were essentially bets on the soundness of these loans. In response to declining housing prices and fears of an impending recession,

9035-462: The September 11 attacks, and hoped that the fall of Hussein's regime would help spread democracy in the Middle East, deter the recruitment of terrorists, and increase the security of Israel . In the days following the September 11 attacks, hawks in the Bush administration such as Wolfowitz argued for immediate military action against Iraq, but the issue was temporarily set aside in favor of planning

9174-541: The Supreme Court in the 2010 case of Citizens United v. FEC . After the passage of the Bush tax cuts and the No Child Left Behind Act, Bush turned his domestic focus to healthcare. He sought to expand Medicare so it would also cover the cost of prescription drugs , a program that became known as Medicare Part D . Many congressional Democrats opposed the bill because it did not allow Medicare to negotiate

9313-516: The U.S. as an occupying force. The fierce fighting of the First Battle of Fallujah alienated many in Iraq, while cleric Muqtada al-Sadr encouraged Shia Muslims to oppose the CPA. Sunni and Shia insurgents engaged in a campaign of guerrilla warfare against the United States, blunting the technological and organizational advantages of the U.S. military. While fighting in Iraq continued, Americans increasingly came to disapprove of Bush's handling of

9452-646: The United States had launched the Gulf War against Iraq after the latter invaded Kuwait . Though the U.S. forced Iraq's withdrawal from Kuwait, it left Saddam Hussein 's administration in place, partly to serve as a counterweight to Iran . After the war, the Project for the New American Century , consisting of influential neoconservatives like Paul Wolfowitz and Cheney, advocated for the overthrow of Hussein. Iraq had developed biological and chemical weapons prior to

9591-406: The United States was the world's lone superpower , it could act unilaterally if necessary. At the same time, Bush sought to enact the less interventionist foreign policy he had promised during the 2000 campaign. Though the first several months of his presidency focused on domestic issues, the Bush administration pulled the U.S. out of several existing or proposed multilateral agreements, including

9730-486: The United States would implement a policy of preemptive military strikes against nations known to be harboring or aiding a terrorist organization hostile to the United States. Bush outlined what he called the " Axis of Evil ," consisting of three nations that, he argued, posed the greatest threat to world peace due to their pursuit of weapons of mass destruction and potential to aid terrorists. The axis consisted of Iraq , North Korea and Iran . Bush also began emphasizing

9869-401: The United States. McCain's 2000 presidential campaign brought the issue of campaign finance reform to the fore of public consciousness in 2001. McCain and Russ Feingold pushed a bipartisan campaign finance bill in the Senate, while Chris Shays (R-CT) and Marty Meehan (D-MA) led the effort of passing it in the House. In just the second successful use of the discharge petition since

10008-557: The White House in the wake of the Dubai Ports World controversy and several botched White House initiatives, and he was replaced by Joshua Bolten. Bolten stripped Rove of some of his responsibilities and convinced Henry Paulson , the head of Goldman Sachs , to replace Snow as secretary of the treasury. After the 2006 elections, Rumsfeld was replaced by former CIA director Robert Gates . The personnel shake-ups left Rice as one of

10147-405: The administration decided to overthrow Afghanistan 's conservative Taliban government, which harbored the leaders of al-Qaeda. Powell took the lead in assembling allied nations in a coalition that would launch attacks on multiple fronts. The Bush administration focused especially on courting Pakistani leader Pervez Musharraf , who agreed to join the coalition. On September 14, Congress passed

10286-502: The bill would actually cost, was negotiating for a new job as a pharmaceutical lobbyist as the bill was working through Congress. 14 congressional aides quit their jobs to work for related lobbies immediately after the bill's passage. In response, free-market think tank Manhattan Institute issued a report by professor Frank Lichtenberg that said the VA National Formulary excludes many new drugs. Only 38% of drugs approved in

10425-526: The city of New Orleans after the failure of that city's levees . Over eighteen hundred people died in the hurricane, and Bush was widely criticized for his slow response to the disaster. Stung by the public response, Bush removed Federal Emergency Management Agency director Michael D. Brown from office and stated publicly that "Katrina exposed serious problems in our response capability at all levels of government." After Hurricane Katrina, Bush's approval rating fell below 40 percent, where it would remain for

10564-457: The cost of both plan liability and the reinsurance subsidy. From 2017 to 2020, despite rising per capita drug spending, premiums decreased by 16%. Plans have been able to lower premiums by negotiating larger rebates from manufacturers and pharmacies. Between 2017 and 2020, the percentage of drug costs rebated back to plans increased from 22% to 28%. In addition, the standard benefit was changed in 2019 to increase mandatory manufacturer discounts in

10703-475: The court battle of Terri Schiavo , a comatose Florida woman who ultimately died. In March 2001, the Bush administration announced that it would not implement the Kyoto Protocol , an international treaty signed in 1997 that required nations to reduce their greenhouse gas emissions. The administration argued that ratifying the treaty would unduly restrict U.S. growth while failing to adequately limit emissions from developing nations. The administration questioned

10842-455: The coverage gap from the perspective of beneficiaries. As of 2020, beneficiary cost-sharing on covered drugs never exceeds 25% of the drug's cost after an enrollee meets their deductible. In 2019, total drug spending for Medicare Part D beneficiaries was about $ 180 billion. One-third of this amount, about $ 120 billion, was paid by prescription drug plans. This plan liability amount was partially offset by about $ 50 billion in discounts, mostly in

10981-505: The creation of a manufacturer discount program. In 2019, about three-quarters of Medicare enrollees obtained drug coverage through Part D. Program expenditures were $ 102 billion, which accounted for 12% of Medicare spending. Through the Part D program, Medicare finances more than one-third of retail prescription drug spending in the United States. To enroll in Part D, Medicare beneficiaries must also be enrolled in either Part A or Part B . Beneficiaries can participate in Part D through

11120-503: The decisions of the Bush administration, particularly the launching of the Iraq War, Powell resigned following the 2004 elections. He was replaced by Rice, while then-deputy national security adviser Stephen Hadley took Rice's former position. Most of Bush's top staffers stayed on after the 2004 election, although Spellings joined the Cabinet as secretary of education and Gonzales replaced Ashcroft as attorney general. In early 2006, Card left

11259-539: The definition of a Part D drug. However plans that cover excluded drugs are not allowed to pass on those costs to Medicare, and plans are required to repay CMS if they are found to have billed Medicare in these cases. Part D plans are not required to pay for all covered Part D drugs. They establish their own formularies, or list of covered drugs for which they will make payment, as long as the formulary and benefit structure are not found by CMS to discourage enrollment by certain Medicare beneficiaries. Part D plans that follow

11398-492: The economy, but news of the failure caused stock prices to tumble and froze credit. Fearing a total financial collapse, Paulson and the Federal Reserve took control of American International Group (AIG), another major financial institution that teetered on the brink of failure. Hoping to shore up the other banks, Bush and Paulson proposed the Emergency Economic Stabilization Act of 2008 , which would create

11537-508: The education of impoverished children, but he strongly opposed the president's proposed school vouchers , which would allow parents to use federal funding to pay for private schools. Both men cooperated to pass the No Child Left Behind Act , which dropped the concept of school vouchers but included Bush's idea of nationwide testing. Both houses of Congress registered overwhelming approval for the bill's final version, which Bush signed into law in January 2002. However, Kennedy would later criticize

11676-599: The face of unified opposition, Republicans abandoned Bush's Social Security proposal in mid-2005. Hurricane Katrina , one of the largest and most powerful hurricanes ever to strike the United States, ravaged several states along the Gulf of Mexico in August 2005. On a working vacation at his ranch in Texas, Bush initially allowed state and local authorities to respond to the natural disaster. The hurricane made landfall on August 29, devastating

11815-537: The fears of critics that this would dissolve the traditional separation of church and state in the United States . To further this commitment, he created the White House Office of Faith-Based and Community Initiatives to assist faith-based service organizations. In 2003, Bush signed the Partial-Birth Abortion Ban Act , which banned intact dilation and extraction , an abortion procedure. Early in his administration, President Bush became personally interested in

11954-465: The federal government. The number of offered plans varies geographically, but a typical enrollee will have dozens of options to choose from. Although plans are restricted by numerous program requirements, plans vary in many ways. Among other factors, enrollees often compare premiums, covered drugs , and cost-sharing policies when selecting a plan. Medicare offers an interactive online tool that allows for comparison of coverage and costs for all plans in

12093-455: The final debate in October, but the unearthing of Bush's 1976 DUI arrest appeared to sap his campaign's momentum. By the end of election night, Florida emerged as the key state in the election, as whichever candidate won the state would win the presidency. Bush held an extremely narrow lead in the vote by the end of election night, triggering an automatic recount . The Florida Supreme Court ordered

12232-628: The findings and recommendations of the Task Force, initial efforts to create a Medicare outpatient drug benefit were unsuccessful. In 1988, the Medicare Catastrophic Coverage Act temporarily expanded program benefits to include self-administered drugs. However, this legislation was repealed just one year later, partially due to concerns regarding premium increases. The 1993 Clinton Health Reform Plan also included an outpatient drug benefit, but that reform effort ultimately failed due to

12371-615: The first Black appointee at that high a level. He was followed by Condoleezza Rice (2005–2009), the first Black woman. Attorney General Alberto Gonzales (2005–2007) was and remains in 2024 the highest appointed Hispanic in the history of American government. In addition Bush appointed the first senior officials who were publicly gay. However he campaigned against quotas, and warned that affirmative action that involved quotas were unacceptable. He deliberately selected minorities known as opponents of affirmative action for key civil rights positions. Thus in 2001 Bush nominated Linda Chavez to be

12510-433: The first Latina in the cabinet as Secretary of Labor. She had to withdraw when it was reported that a decade earlier she had hired an illegal immigrant. Upon taking office, Bush had little experience with foreign policy, and his decisions were guided by his advisers. Bush embraced the views of Cheney and other neoconservatives , who de-emphasized the importance of multilateralism ; neoconservatives believed that because

12649-606: The first director of the newly created department. The department was charged with overseeing immigration, border control, customs, and the newly established Transportation Security Administration (TSA), which focused on airport security . Though the FBI and CIA remained independent agencies, the DHS was assigned jurisdiction over the Coast Guard , the Immigration and Naturalization Service (which

12788-541: The first of many challenges the U.S. would face in keeping the peace in Iraq. Bush appointed Paul Bremer to lead the Coalition Provisional Authority (CPA), which was charged with overseeing the transition to self-government in Iraq. In his first major order, Bremer announced a policy of de-Ba'athification , which denied government and military jobs to members of Hussein's Ba'ath Party . This policy angered many of Iraq's Sunnis , many of whom had joined

12927-474: The first year after Part D, there was no evidence of improvement in emergency department use, hospitalizations, or preference-based health utility for those eligible for Part D during its first year of implementation. It was also found that there were no significant changes in trends in the dual eligibles' out-of-pocket expenditures, total monthly expenditures, pill-days, or total number of prescriptions due to Part D. A 2020 study found that Medicare Part D led to

13066-411: The following days, Bush urged the public to renounce hate crimes and discrimination against Muslim-Americans and Arab-Americans . He also declared a " War on Terror ", instituting new domestic and foreign policies in an effort to prevent future terrorist attacks. As Bush's top foreign policy advisers were in agreement that merely launching strikes against al-Qaeda bases would not stop future attacks,

13205-774: The form of manufacturer and pharmacy rebates. This implied a net plan liability (i.e. net of discounts) of roughly $ 70 billion. To finance this cost, plans received roughly $ 50 billion in federal reinsurance subsidies, $ 10 billion in federal direct subsidies, and $ 10 billion in enrollee premiums. In addition to the $ 60 billion paid in federal insurance subsidies, the federal government also paid about $ 30 billion in cost-sharing subsidies for low-income enrollees. The federal government also collected roughly 20 billion in offsetting receipts. These offsets included both state payments made on behalf of Medicare beneficiaries who also qualify for full Medicaid benefits and additional premiums paid by high-income enrollees. After accounting for these offsets,

13344-506: The formulary classes and categories established by the United States Pharmacopoeia will pass the first discrimination test. Plans can change the drugs on their formulary during the course of the year with 60 days' notice to affected parties. The primary differences between the formularies of different Part D plans relate to the coverage of brand-name drugs. Typically, each Plan's formulary is organized into tiers, and each tier

13483-602: The fourth person to win the presidency while losing the popular vote . In the concurrent congressional elections , Republicans retained a narrow majority in the House of Representatives , but lost five seats in the Senate , leaving the partisan balance in the Senate at fifty Republicans and fifty Democrats. Rejecting the idea of a powerful White House chief of staff , Bush had high-level officials report directly to him rather than Chief of Staff Andrew Card . Vice President Cheney emerged as

13622-421: The full low-income subsidy, while others are eligible for a partial subsidy. All low-income subsidy enrollees still pay small copayment amounts. Low-income enrollees tend to have more chronic conditions than other enrollees. Low-income subsidy enrollees represent about one-quarter of enrollment, but about half of the program's retail drug spending. Nearly 30% of Federal spending on Part D goes towards paying for

13761-453: The government again run deficits. The Economic Growth and Tax Relief Reconciliation Act of 2001 won the support of congressional Republicans and a minority of congressional Democrats, and Bush signed it into law in June 2001. The act lowered the top income tax rate from 39 percent to 35 percent, and it also reduced the estate tax . The narrow Republican majority in the Senate necessitated the use of

13900-524: The greater of a 5% coinsurance amount or a nominal co-payment amount. These three benefit phases are referred to as the Deductible, Initial Coverage Limit, and the Catastrophic phase. The "Out-of-Pocket Threshold" is not a cap on out-of-pocket spending, as beneficiaries continue to accrue cost-sharing expenses in the Catastrophic phase. In 2020, beneficiaries would typically reach this threshold as their retail drug spending approached $ 10,000. When patients enter

14039-617: The implementation of the act, arguing that Bush had promised greater federal funding for education. Shortly after the September 11 attacks , Bush announced the creation of the Office of Homeland Security and appointed former governor of Pennsylvania Tom Ridge its director. After Congress passed the Homeland Security Act to create the Department of Homeland Security (DHS), Ridge became

14178-423: The importance of spreading democracy worldwide, stating in 2005 that "the survival of liberty in our land depends on the success of liberty in other land." Pursuant to this newly interventionist policy, the Bush administration boosted foreign aid and increased defense expenditures. Defense spending rose from $ 304 billion in fiscal year 2001 to $ 616 billion in fiscal year 2008. During the presidency of his father ,

14317-504: The invasion of Afghanistan. Beginning in September 2002, the Bush administration mounted a campaign designed to win popular and congressional support for the invasion of Iraq. In October 2002, Congress approved the Iraq Resolution , authorizing the use of force against Iraq. While congressional Republicans almost unanimously supported the measure, congressional Democrats were split in roughly equal numbers between support and opposition to

14456-466: The invasion was strongly criticized by many countries ; UN secretary-general Kofi Annan argued that the invasion was a violation of international law and the U.N. Charter . On May 1, 2003, Bush delivered the " Mission Accomplished speech ," in which he declared the end of "major combat operations" in Iraq. Despite the failure to find evidence of an ongoing WMD program or an operational relationship between Hussein and al-Qaeda , Bush declared that

14595-560: The issue of stem cell research. The Clinton administration had issued guidelines allowing the federal funding of research utilizing stem cells, and Bush decided to study the situation's ethics before issuing his own executive order on the issue. Evangelical religious groups argued that the research was immoral as it destroyed human embryos , while various advocacy groups touted the potential scientific advances afforded by stem cell research. In August 2001, Bush issued an executive order banning federal funding for research on new stem cell lines;

14734-464: The low-income premium subsidy. For 2022, costs for stand-alone Part D plans in the 10 major U.S. markets ranged from a low of $ 6.90-per-month (Dallas and Houston) to as much as $ 160.20-per-month (San Francisco). A study by the American Association for Medicare Supplement Insurance reported the lowest and highest 2022 Medicare Plan D costs for the top-10 markets. Retiree Drug Subsidy (RDS) is

14873-604: The low-income subsidy. In addition to receiving premium and cost-sharing subsidies, certain program rules apply differently for low-income subsidy enrollees. Beneficiaries of the low-income subsidy are exempt from the Coverage Gap Manufacturer Discount Program. Low-income subsidy enrollees are also allowed to change plans more frequently than other enrollees. While Centers for Medicare & Medicaid Services (CMS) does not have an established formulary, Part D drug coverage excludes drugs not approved by

15012-466: The mid-2000s. In the 2000 presidential election, both the Democratic and Republican candidates campaigned on the promise of using the projected federal budget surplus to fund a new Medicare drug entitlement program. Following his electoral victory, President George W. Bush promoted a general vision of using private health plans to provide drug coverage to Medicare beneficiaries. Rather than demand that

15151-579: The most powerful individual in the White House aside from Bush himself. Bush brought to the White House several individuals who had worked under him in Texas, including Senior Counselor Karen Hughes , Senior Adviser Karl Rove, legal counsel Alberto Gonzales , and Staff Secretary Harriet Miers . Other important White House staff appointees included Margaret Spellings as a domestic policy adviser, Michael Gerson as chief speechwriter, and Joshua Bolten and Joe Hagin as White House deputy chiefs of staff. Paul H. O'Neill , who had served as deputy director of

15290-412: The most prominent individuals in the administration, and she played a strong role in directing Bush's second term foreign policy. Gonzales and Rove both left in 2007 after controversy regarding the dismissal of U.S. attorneys, and Gonzales was replaced by Michael Mukasey , a former federal judge. After the 2004 election, many expected that the aging Chief Justice William Rehnquist would step down from

15429-539: The need for regime change, and the latter three countries each possessed veto power on the United Nations Security Council . At the behest of British prime minister Tony Blair , who supported Bush but hoped for more international cooperation, Bush dispatched Powell to the U.N. to make the case to the Security Council that Iraq maintained an active WMD program. Though Powell's presentation preceded

15568-635: The net federal cost of Part D was about $ 70 billion. A 2008 study found that the percentage of Medicare beneficiaries who reported forgoing medications due to cost dropped with Part D, from 15.2% in 2004 and 14.1% in 2005 to 11.5% in 2006. The percentage who reported skipping other basic necessities to pay for drugs also dropped, from 10.6% in 2004 and 11.1% in 2005 to 7.6% in 2006. The very sickest beneficiaries reported no reduction, but fewer reported forgoing other necessities to pay for medicine. A parallel study found that Part D beneficiaries skip doses or switch to cheaper drugs and that many do not understand

15707-479: The order allowed research on existing stem cell lines to continue. In July 2006, Bush used his first presidential veto on the Stem Cell Research Enhancement Act , which would have expanded federal funding of embryonic stem cell research. A similar bill was passed in both the House of Representatives and the Senate early in mid-2007 as part of House Speaker Nancy Pelosi 's 100-Hour Plan , but

15846-463: The plan at a higher co-pay, perhaps $ 70 to $ 100. Tiers 4 and higher typically contain specialty drugs , which have the highest co-pays because they are generally more expensive. By 2011 in the United States a growing number of Medicare Part D health insurance plans had added the specialty tier . Upon enactment in 1965, Medicare included coverage for physician-administered drugs, but not self-administered prescription drugs. While some earlier drafts of

15985-481: The plan be budget neutral, President Bush supported up to $ 400 billion in new spending for the program. In 2003, President Bush signed the Medicare Modernization Act , which authorized the creation of the Medicare Part D program. The program was implemented in 2006. To keep the plan's cost projections below the $ 400 billion constraint set by leadership, policymakers devised the infamous “ donut hole .” After exceeding

16124-417: The position of chief justice, but instead chose to nominate Roberts for the position. Roberts won confirmation from the Senate in a 78–22 vote, with all Republicans and a narrow majority of Democrats voting to confirm Roberts. To replace O'Connor, the Bush administration wanted to find a female nominee, but was unsatisfied with the conventional options available. Bush settled on Miers, who had never served as

16263-488: The prices of drugs, while many conservative Republicans opposed the expansion of the government's involvement in healthcare. Assisted by Speaker of the House Dennis Hastert and Senate majority leader Bill Frist , Bush overcame strong opposition and won passage of his Medicare bill. In December 2003, Bush signed the Medicare Prescription Drug, Improvement, and Modernization Act , the largest expansion of Medicare since

16402-460: The program's creation in 1965. After winning re-election in 2004, Bush made the partial privatization of Social Security his top domestic priority. He proposed restructuring the program so that citizens could invest some of the money they paid in payroll taxes , which fund the Social Security program. The president argued that Social Security faced an imminent funding crisis and that reform

16541-474: The program, drug benefits are provided by private insurance plans that receive premiums from both enrollees and the government. Part D plans typically pay most of the cost for prescriptions filled by their enrollees. However, plans are later reimbursed for much of this cost through rebates paid by manufacturers and pharmacies. Part D enrollees cover a portion of their own drug expenses by paying cost-sharing . The amount of cost-sharing an enrollee pays depends on

16680-460: The program. Another study found that Part D resulted in modest increases in average drug utilization and decreases in average out-of-pocket expenditures. Further studies by the same group of researchers found that the net impact among beneficiaries was a decrease in the use of generic drugs. A further study concludes that although a substantial reduction in out-of-pocket costs and a moderate increase in utilization among Medicare beneficiaries during

16819-645: The public and did not do enough to reduce carbon emissions and deter global warming. On January 6, 2009, President Bush designated the world's largest protected marine area. The Pacific Ocean habitat includes the Mariana Trench and the waters and corals surrounding three uninhabited islands in the Northern Mariana Islands , Rose Atoll in American Samoa, and seven islands along the equator. In July 2002, following several accounting scandals such as

16958-538: The resolution. Bowing to domestic and foreign pressure, Bush sought to win the approval of the United Nations before launching an attack on Iraq. Led by Powell, the administration won the November 2002 passage of United Nations Security Council Resolution 1441 , which called on Iraq to dismantle its WMD program. Meanwhile, senior administration officials became increasingly convinced that Iraq did indeed possess WMDs and

17097-422: The rest of his tenure in office. Although he concentrated on other domestic policies during his first term, Bush supported immigration reform throughout his administration. In May 2006, he proposed a five-point plan that would increase border security , establish a guest worker program , and create a path to citizenship for the twelve million illegal immigrants living in the United States. The Senate passed

17236-457: The rest of the country. While the Karzai's government struggled to control the countryside, the Taliban regrouped in neighboring Pakistan. As Bush left office, he considered sending additional troops to bolster Afghanistan against the Taliban, but decided to leave the issue for the next administration. After the September 11 attacks, Bush's approval ratings increased tremendously. Inspired in part by

17375-436: The retail cost of the filled drug, the rules of their plan, and whether they are eligible for additional Federal income-based subsidies. Prior to 2010, enrollees were required to pay 100% of their retail drug costs during the coverage gap phase , commonly referred to as the "doughnut hole.” Subsequent legislation, including the Affordable Care Act , “closed” the doughnut hole from the perspective of beneficiaries, largely through

17514-559: The same position during the Ford administration , rounded out the key figures in the national security team. Rumsfeld and Cheney, who had served together in the Ford administration, emerged as the leading foreign policy figures during Bush's first term. O'Neill, who opposed the Iraq War and feared that the Bush tax cuts would lead to deficits, was replaced by John W. Snow in February 2003. Frustrated by

17653-611: The surrounding area and inserted CIA and special forces operatives who linked up with the Northern Alliance , an Afghan resistance group opposed to the Taliban. The second phase consisted of a major air campaign against Taliban and al-Qaeda targets, while the third phase involved the defeat of the remaining Taliban and al-Qaeda forces. The fourth and final phase consisted of the stabilization of Afghanistan, which Franks projected would take three to five years. The war in Afghanistan began on October 7 with several air and missile strikes, and

17792-554: The task force in spring 2011, leaving obscenity prosecutions to the United States Department of Justice Criminal Division 's Child Exploitation and Obscenity Section . This United States government–related article is a stub . You can help Misplaced Pages by expanding it . Presidency of George W. Bush George W. Bush 's tenure as the 43rd president of the United States began with his first inauguration on January 20, 2001, and ended on January 20, 2009. Bush,

17931-399: The tax cut's size and the possibility of future deficits, Vice President Cheney took charge of writing the bill, which the administration proposed to Congress in March 2001. Bush initially sought a $ 1.6 trillion tax cut over a ten-year period, but ultimately settled for a $ 1.35 trillion tax cut. The administration rejected the idea of "triggers" that would phase out the tax reductions should

18070-506: The time of Medicare's passage, more than 90% of drug spending was paid out-of-pocket. Over the following 35-years, third-party payment for prescription drugs became increasingly common. By the end of the century, less than one-third of drug spending was paid out-of-pocket. Despite the absence of a Medicare drug benefit, about 70% of Medicare enrollees obtained drug coverage through other means, often through an employer or Medicaid . Medicare began offering subsidized outpatient drug coverage in

18209-414: The toppling of Hussein "removed an ally of al-Qaeda" and ended the threat that Iraq would supply weapons of mass destruction to terrorist organizations. Believing that only a minimal residual American force would be required after the success of the invasion, Bush and Franks planned for a drawdown to 30,000 U.S. troops in Iraq by August 2003. Meanwhile, Iraqis began looting their own capital, presenting one of

18348-579: The weak economy. Though TARP helped end the financial crisis, it did not prevent the onset of the Great Recession , which would continue after Bush left office. On his first day in office, President Bush reinstated the Mexico City policy , thereby blocking federal aid to foreign groups that offered assistance to women in obtaining abortions . Days later, he announced his commitment to channeling more federal aid to faith-based service organizations, despite

18487-595: Was briefed on al-Qaeda's activities, but focused on other foreign policy issues during his first months in office. On September 11, 2001, al-Qaeda terrorists hijacked four airliners and flew two of them into the twin towers of the World Trade Center in New York City , destroying both 110-story skyscrapers. A third plane crashed into Pentagon , and a fourth plane was brought down in Pennsylvania following

18626-716: Was divided into three agencies), the United States Customs Service (which was also divided into separate agencies), and the Federal Emergency Management Agency . The Homeland Security Act represented the most significant departmental reorganization since the National Security Act of 1947 . On October 26, 2001, Bush signed into law the Patriot Act . Passed on the president's request, the act permitted increased sharing of intelligence among

18765-470: Was likely to furnish those WMDs to al-Qaeda; CIA Director George Tenet assured Bush that it was a "slam dunk" that Iraq possessed a stockpile of WMDs. After a U.N. weapons inspections team led by Hans Blix , as well as another team led by Mohamed ElBaradei , failed to find evidence of an ongoing Iraqi WMD program, Bush's proposed regime change in Iraq faced mounting international opposition. Germany, China, France, and Russia all expressed skepticism about

18904-567: Was necessary to ensure its continuing solvency. Bush expected a difficult congressional battle over his proposal, but, as he put it, "I've got political capital, and I intend to spend it." Groups like the AARP strongly opposed the plan, as did moderate Democrats like Max Baucus , who had supported the Bush tax cuts. Ultimately, Bush failed to win the backing of a single congressional Democrat for his plan, and even moderate Republicans like Olympia Snowe and Lincoln Chafee refused to back privatization. In

19043-600: Was staunchly opposed to euthanasia and supported Attorney General John Ashcroft's ultimately unsuccessful suit against the Oregon Death with Dignity Act . However, while he was governor of Texas , Bush had signed a law giving hospitals the authority to remove life support from terminally ill patients against the wishes of spouses or parents, if the doctors deemed it as medically appropriate. This perceived inconsistency in policy became an issue in 2005, when Bush signed controversial legislation to initiate federal intervention in

19182-437: Was succeeded by Democrat Barack Obama , who won the 2008 presidential election . He is the eldest son of the 41st president, George H. W. Bush . A decisive event reshaping Bush's administration was the September 11, 2001 event. In its aftermath, Congress created the United States Department of Homeland Security and Bush declared a global war on terrorism . He ordered an invasion of Afghanistan in an effort to overthrow

19321-543: Was vetoed by Bush. After the Supreme Court struck down a state sodomy law in the 2003 case of Lawrence v. Texas , conservatives began pushing for the Federal Marriage Amendment , which would define marriage as a union between a man and a woman. Bush endorsed this proposal and made it part of his campaign during the 2004 and 2006 election cycles. However, President Bush did break from his party in his tolerance of civil unions for homosexual couples. Bush

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