House passes health reform

Medicare overhaul includes drug benefit

3-hour vote ends at 220-215

Kennedy announces plan to block bill in Senate

November 23, 2003|By Julie Hirschfeld Davis | Julie Hirschfeld Davis,SUN NATIONAL STAFF

WASHINGTON - The Republican-controlled House approved a sweeping Medicare overhaul just before sunrise yesterday, after a climactic night spent just barely rescuing the measure from defeat at the hands of conservatives and Democrats.

Senate leaders began pushing to gain approval of the bill before Thanksgiving and were debating the measure through the weekend. The 220-215 House vote cleared away the largest obstacle to enactment of the legislation, a historic expansion of the 38-year-old Medicare program that would add prescription drug benefits and hand the private sector a new role in providing health care to seniors.

But it also appeared to lend new urgency to Democratic efforts on both sides of the Capitol to vilify the bill. Hours after the House vote, another stumbling block emerged in the Senate when a key Democrat, Sen. Edward M. Kennedy of Massachusetts, announced plans to block the bill.

That strategy could carry with it substantial political risks for the party, given seniors' strong support for the idea of having the government help them pay for their medicines.

"There is a strong bipartisan majority in the United States Senate in favor of the Medicare prescription drug legislation now before us," said Senate Majority Leader Bill Frist, a Tennessee Republican. "Those who would support a cruel filibuster of this bill would hold our parents and grandparents - 40 million American seniors - hostage to politics."

Final approval of the measure would give President Bush and congressional Republicans a potent political victory less than one year before the 2004 elections, delivering to seniors - who vote in disproportionately large numbers - one of their highest priorities.

"We're on the verge of success," Bush said in his weekly radio address, delivered just hours after the House approved the measure with strenuous lobbying - including pre-dawn telephone calls - from the president. "I urge all members of Congress to remember what is at stake, and to remember the promise we have made to America's seniors."

The narrow House victory came after an extraordinary vote lasting nearly three hours that saw Republican leaders successfully browbeating conservative opponents into switching their votes. "We literally worked years to get to this point," House Speaker Dennis Hastert of Illinois said as he strode off the floor after the vote. "I wasn't about to give it up until we got it done."

House Democrats accused Republicans of cheating to get their desired outcome and prolonging what was to have been a 15-minute voting period until they turned a defeat into a win. "We had prevailed on this vote," said Rep. Steny H. Hoyer of Southern Maryland, the Democratic whip. "Arms have been twisted and votes changed."

The House action injected a distinctly partisan tinge into Senate debate on the Medicare measure. Kennedy, his party's most trusted voice on health care issues, said the "outrageous" tactics Republicans used to push the measure through the House in the wee hours of the morning had persuaded him to work to block it.

"It was a phony vote in the House of Representatives, and now they're trying to jam us in the Senate," Kennedy told reporters in his Capitol office. "We demean, I think, the Medicare program, we fail our senior citizens, and I think we demean the institution by rolling over."

Proponents in both parties were gaining in their efforts to round up support for the measure in the Senate, and Minority Leader Tom Daschle, a South Dakota Democrat, has said he would not support attempts to filibuster the bill. Kennedy acknowledged successfully doing so would be "an uphill battle."

Frist moved yesterday afternoon to cut off the filibuster with a vote scheduled for tomorrow evening, and backers continued to seek the 60 votes they would need to do so.

The Medicare measure proved a much heavier lift in the House, where almost all Democrats and a determined bloc of conservatives refused to support it, albeit for different reasons.

Democrats denounced the bill, the centerpiece of which is a $400 billion prescription drug benefit, saying it provides inadequate coverage for seniors while taking damaging steps toward dismantling Medicare. They said it would transform Medicare from a guaranteed entitlement to a privately run program that shifts the ballooning cost of health care from the government to seniors, allowing pharmaceutical companies and insurers to reap a windfall.

Conservatives, for their part, said the measure did not do enough to inject private-sector competition into Medicare, missing an opportunity to control costs in the program while adding an expensive new government-provided benefit.

Knowing they faced near-monolithic opposition among Democrats, Republican leaders worked feverishly Friday trying to sway the roughly 25 conservative opponents among their ranks to support the measure.

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