Rick Santorum claims he “held his nose” while voting for a huge expansion of Medicare in 2003, but the White House hopeful played an active role in passing the controversial law.



Santorum’s support for the GOP’s effort to enact a Medicare prescription drug benefit has attracted criticism from conservatives. The law has long been cited by the right as Exhibit A of how Republicans lost their way on government spending during President George W. Bush’s two terms.



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During a CNN interview Wednesday following his strong performance in the Iowa caucuses, the former senator said, “One of the reasons I held my nose and voted for it was because we did have the private sector model for Medicare prescription drugs…”But Santorum’s role in passing the law is larger than he has suggested.As the third-ranking Senate Republican leader nine years ago, Santorum urged his colleagues to vote for the drug benefit. In an October 2003 memo to Senate Republicans, Santorum warned that Democrats had gained traction on domestic issues.Santorum wrote that passage of the Medicare drug plan was key to winning over independent voters, adding that “the political consequence is clear if the GOP does not act,” according to a media report at the time.In 2003, the GOP had control over the House, the Senate and the White House. Passing the drug benefit was seen as a key to Bush’s 2004 reelection bid. Seniors, a crucial voting bloc, were outraged at the cost of prescription drugs and were calling for policymakers to act.Republicans struggled to round up the votes as conservatives rallied against the legislation, which was estimated to cost nearly $400 billion over 10 years with no offsets.Most Democrats, who charged that the bill was written by the HMO and pharmaceutical industries, were pushing for a far more expensive drug benefit.The Republican bill passed the House after GOP leaders held open the vote for three hours to persaude skeptical rank-and-file members. The bill later narrowly cleared a procedural vote in the Senate and passed the upper chamber.The only two Senate Republicans who defected on the procedural motion were(Ariz.) and(Neb.), who has since retired.The Medicare drug benefit debate put Santorum in an awkward spot. He didn’t support a universal benefit, preferring it be targeted at low-income seniors. His position put him at odds with Bush, at least for a while.Santorum voted against an earlier version of the legislation, which had attracted the support of the late Sen. Edward Kennedy (D-Mass.).But after it was merged with the House-passed version and sent to Bush’s desk, Santorum called it a “landmark” bill.He added, “This is a historic opportunity to bring Medicare more into line with 21st century medicine. The Senate’s action today delivers on an important promise to America’s seniors — meaningful voluntary prescription drug benefits under Medicare and enhanced healthcare options.”He has since said he wished the bill had been paid for, and went so far as to say his “yes” vote was a “mistake” during an interview on Fox News.Yet, he has also defended aspects of the law, hailing the creation of health savings accounts and asserting it has similarities to the contentious Medicare reform plan offered by House Budget Committee Chairman(R-Wis.) last year. Ryan, who is considered a possible vice-presidential candidate, also voted for the pharmaceutical benefit in 2003.Unlike then-Senate Majority Leader Bill Frist (R-Tenn.) and then-Speaker Dennis Hastert (R-Ill.), Santorum did not lead the charge for the bill in 2003. But he did speak out in favor of it on various occasions before its final passage.As a Senate Republican leader, it would have been politically difficult for Santorum to vote against Bush on the Medicare drug benefit. But years later, Santorum did not shy away from publicly criticizing Bush on his immigration reform plan, likening it to “amnesty.”It remains to be seen if Republican presidential candidates will challenge Santorum on the drug benefit in this weekend’s debates before the New Hampshire primary.During a CNN presidential debate last year, Mitt Romney and Rick Perry said they would not repeal the popular law, though they have made an argument for putting Medicare on more sound fiscal footing. Santorum also said he would not repeal the benefit, but vowed to pay for it.Former Speaker Newt Gingrich (R-Ga.) was outspoken in his support of the 2003 bill, pleading with his former colleagues to back it in the days before the final vote.Santorum’s vote could be used against him as part of an argument that the ex-Senate leader is not as conservative as he says he is.Ron Paul, who voted “no” on the 2003 Medicare bill, has called Santorum “very liberal,” citing his record on government spending.

McCain, who endorsed Romney this week, has gone after Santorum’s fondness for earmarks.



Right-wing blogs have noted Santorum’s Medicare vote while also pointing out that the White House hopeful backed then-Sen. Arlen Specter (R-Pa.) over Pat Toomey in their 2004 primary.



Specter eked by Toomey, retained his seat and bolted the GOP in 2009. He subsequently helped Democrats pass President Obama’s healthcare reform law.



Earlier this week, Michele Bachmann Michele Marie BachmannEvangelicals shouldn't be defending Trump in tiff over editorial Mellman: The 'lane theory' is the wrong lane to be in White House backs Stephen Miller amid white nationalist allegations MORE, who has since dropped out of the presidential race, said Santorum “supported Arlen Specter and endorsed him. Arlen Specter supplied the 60th vote that gave us ObamaCare...”



Santorum on Wednesday said, “The reason I am in this race is because of ObamaCare. I think ObamaCare will turn every American into a dependent American, someone who will be relying on the federal government.”



Santorum’s campaign did not comment for this article.