Medicare overhaul moves forward

GOP leaders in Congress make a breakthrough on adding drug benefit

Final OK possible within days

November 16, 2003|By Julie Hirschfeld Davis | Julie Hirschfeld Davis,SUN NATIONAL STAFF

WASHINGTON - Top House and Senate Republican leaders reached crucial breakthroughs yesterday on Medicare legislation that would add prescription drug benefits to the federal health program for the elderly and hand private insurers a major role in providing health care to seniors.

The deal, reached with 11th-hour prodding by Senate Majority Leader Bill Frist of Tennessee and House Speaker Dennis Hastert of Illinois, could spark broad agreement and provide the impetus for Congress to give final approval to the $400 billion Medicare measure as early as this week.

"We feel very good about the progress that's been made, and very optimistic that we're going to be able to send a bipartisan bill to the president of the United States" within days, Frist said.

Frist, a physician, appeared yesterday evening in his Capitol office with top Republican negotiators and two Democrats, Sens. Max Baucus of Montana and John B. Breaux of Louisiana, who have tentatively signed onto the agreement.

"I think we're there," said Baucus, adding that the negotiators had "very strong agreement in principle." Baucus has not given a final blessing to the agreement, details of which will not be released publicly until this afternoon.

The measure still faces an uncertain future on Capitol Hill, especially in the Senate, where most Democrats and a handful of Republicans oppose bringing private-sector competition to Medicare, arguing that it could open seniors to huge increases in their health care premiums and that it would undermine the foundations of the 38-year-old program.

"I remain deeply troubled that this plan will undermine the reliability and affordability of Medicare for our nation's seniors," Sen. Edward M. Kennedy of Massachusetts, one of the most influential Democratic voices on health care, said in a statement.

Kennedy has begun rounding up votes against the measure in the hopes of launching a filibuster to kill it, and 44 senators - including seven Republicans - signed a letter last week saying they oppose it. Democrats would need only 41 votes to block the measure using procedural tactics.

Appearing at the Iowa Democratic Party's annual Jefferson Jackson dinner last night in Des Moines, Iowa, Sen. Hillary Rodham Clinton of New York said the proposal "will end Medicare as we know it."

But Breaux said the only thing that could stall the package is "unnecessary political partisanship. This is one issue that both sides have to set that aside for one moment and get this done for the people who truly, really need it."

Adding prescription drug benefits to Medicare, the most far-reaching change in the program since its inception, is a priority of senior citizens - a politically active bloc. It has broad popularity and strong political appeal in both parties. Bush and the Republicans who control Congress have promised voters that they would deliver the legislation, a goal that eluded former President Bill Clinton and Democratic leaders when they were in power.

"The time for delay and deadlock has passed. Now is the time for action," Bush said in his weekly radio address yesterday. "Congress has an historic opportunity to give all our seniors prescription drug coverage, health care choices and a healthier, more secure retirement. We must make these improvements this year, during this session of Congress."

The idea of having Medicare compete directly with private companies to provide health care to seniors, an approach often called "premium support," is far more controversial.

But with broad consensus emerging in recent years that Congress must act to add prescription drug coverage to Medicare, many Republicans and a few key Democrats have seized on premium support as one of the only ways to control costs in the quickly growing program, which experts say is now on track to go broke if it continues exploding at its current rates.

In addition to the 40 million seniors who will benefit from the legislation, said Rep. Bill Thomas, a California Republican and chairman of the Ways and Means Committee, "there are also 100-plus million taxpayers that are going to be a little better off because they won't have to shoulder quite the proportional load that they've had to over recent years."

Senior aides said leaders reached agreement yesterday on the competition issue and on subsidies to encourage companies that provide health care coverage to their retirees to continue doing so once the new drug benefits start.

Negotiators coalesced weeks ago on the drug benefit itself, which would begin in 2006. Until then, seniors would receive a card that would give them discounts of 10 to 25 percent on prescription medicines.

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