Healthy Skepticism Library item: 1270

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Publication type: news

Espo D.
Medicare Deal Would Offer Equal Coverage
Associated Press 2003 Jun 5

Full text:

WASHINGTON – The drive to provide prescription drug benefits under Medicare gained ground on Thursday as leading members of the Senate Finance Committee unveiled a $400 billion bipartisan plan to offer equal coverage to all seniors, regardless of how they receive their health care.

As outlined by Sens. Charles Grassley, R-Iowa, and Max Baucus, D-Montana, the measure also envisions creation of a new managed care option for Medicare along the lines of preferred-providers organizations that are in widespread use in private industry.

These plans would offer preventive health coverage as well as protection against catastrophic health care expenses, neither of which is currently available under the government-run program.

In a statement, the White House said President Bush was encouraged by the agreement, and added, “We have a real opportunity to get something done this year.” At the same time, Bush stopped short of an endorsement.

The president prefers an approach that offers a more generous drug benefit to seniors who will enroll in a Medicare preferred-provider organization than to those who remain in the traditional program – an idea that both Grassley and Baucus stressed they had rejected in fashioning their agreement.

“The benefit is equal for everyone, both in traditional Medicare and in the enhanced Medicare we’re setting up,” Grassley said. The Iowa Republican said the panel would meet next Thursday to vote on the measure.

“Unlike the president’s proposal, we’re not using carrots to entice or coerce seniors into plans that might not work for them,” added Baucus, the senior Democrat on the Finance Committee.

Beginning in 2004, beneficiaries would be eligible for a discount card that would allow them to purchase prescription drugs at a discount. Two years later, the insurance coverage would begin.

Aides said that beneficiaries enrolled in traditional Medicare could purchase stand-alone drug coverage for a premium of roughly $35 a month.

The plan would carry a deductible of $275, after which the individual would be required to pay 50 percent of the bill until total costs reached $3,450. From that point until costs reached $5,300, the individual would pay 100 percent of the bill. Beyond that level, insurance would pay 90 percent, and the individual 10 percent.

The government would subsidize expenses for low-income beneficiaries.

These aides, who provided details on condition of anonymity, stressed that the details could change, depending on cost estimates yet to be prepared by the Congressional Budget Office.

Seniors who choose to enroll in the new PPO Medicare option would receive drug benefits as part of their overall coverage.

Prescription drug legislation has passed the House twice in recent years, but has fallen victim to partisan battles in the Senate both times.

This time, Majority Leader Bill Frist of Tennessee has said he intends to have legislation on the floor of the Senate for debate during the last two weeks of June. And while the agreement between Grassley and Baucus had its critics – Republicans and Democrats alike – their announcement was one in a series of recent indications that this time legislation could make it out of the Senate intact.

Frist issued a statement saying that while there was “a long way to go,” the day’s announcement marked a positive step toward strengthening Medicare and providing drug assistance.

Sen. Edward M. Kennedy, D-Mass., a leading Democratic voice on Medicare, said Grassley and Baucus had achieved a “major breakthrough in our effort to give senior citizens the prescription drug coverage under Medicare they need and deserve.” At the same time, Kennedy said, “the fight is far from over,” and Democrats would continue to press for additional funding and other changes.

He stopped well short of signaling a major battle over the issue when the bill reaches the floor.

Aides said Senate Democratic Leader Tom Daschle had objections to the legislation, as well. But he, too, has not threatened a filibuster.

Among Republicans, aides said leaders were concerned that Grassley had not yet been able to persuade a majority of GOP members of the Finance Committee to support the measure. Many conservatives favor Bush’s approach of using a drug benefit as a sweetener to persuade seniors to move into PPO Medicare plans.