- The Washington Times - Friday, June 6, 2003

The Senate’s new, bipartisan compromise to provide seniors with prescription-drug coverage drew praise from some members of the Senate Finance Committee during a hearing yesterday, but faced concerns from both sides of the aisle.

A top administration official told committee members the administration has “a lot of questions” about the bill and would prefer to see more incentives for seniors to move from traditional Medicare to private plans.

“We’d like to ensure that people move into what we consider more efficient plans as quickly as possible,” said Thomas Scully, head of the Centers for Medicare and Medicaid Services. Still, he said, the president wants to get a proposal passed and feels it is up to Congress to legislate the details. The administration is pleased at the committee’s bipartisan effort and wants “to keep momentum moving in the right direction,” Mr. Scully said.

The compromise bill — announced Thursday by Finance Committee Chairman Sen. Charles E. Grassley, Iowa Republican, and the committee’s ranking Democrat, Sen. Max Baucus of Montana — would create a $400 billion prescription drug benefit for seniors that would be equivalent whether they choose to stay in the traditional Medicare program or move to a new option, Medicare Advantage.

The new option would use private insurance plans, like preferred provider organizations (PPOs), to deliver comprehensive health coverage, including a drug benefit.

Low-income seniors would receive more help with their drugs under the bill.

President Bush and Republicans had pushed the new Medicare Advantage idea, but wanted it to offer a more robust drug benefit in order to entice seniors to go into private plans. Mr. Scully said private plans will end up offering a “much more efficient insurance package” with “much better benefits” than traditional Medicare. In order for that setup to work, however, a sufficient number of people would have to choose it.

But Marilyn Moon, senior fellow at the Urban Institute, a nonpartisan social policy organization that has an interest in low-income Americans, said PPOs have higher administrative costs than Medicare and incur additional costs to beneficiaries if they choose a doctor out of the PPO network.

Mr. Baucus said the bill was “a good start toward helping seniors.” Sen. John B. Breaux, Louisiana Democrat and a key negotiator in the process, praised the bill, saying it “combines the best of what the government can do with the best of what the private sector can do.”

But there were concerns.

Sen. Don Nickles, Oklahoma Republican, said Congress should be sure that the program it is creating will be “affordable and sustainable” in the future. “I’m worried about that; I’m very worried,” he said.

He also worried that the bill’s proposed drug coverage for low-income seniors was too generous and could lead to overuse of drugs.

Senate Minority Leader Tom Daschle complained that a lot of money in the bill goes toward enticing the private plans to deliver the benefits, while it could go directly to seniors to help with their drug costs. The South Dakota Democrat also criticized a gap in drug coverage under the bill, during which seniors would have to pick up drug costs.

Other Democrats were downright angry.

“I’ve never been through a process as bad as this,” said West Virginia Sen. John D. Rockefeller IV, complaining that he had not been included in bill discussions and has not seen details of the measure.

Sen. Kent Conrad, North Dakota Democrat, agreed with the criticism. “I’ve not seen any serious description of this plan yet,” he said.

Many Democrats fear the president and conservatives want to weaken and eventually dismantle Medicare.

The Finance Committee plans to mark up the bill next week. Mr. Grassley and Mr. Baucus said the actual language of the bill has not been released because they are waiting for cost estimates from the Congressional Budget Office, which could mean changes.

Senate Majority Leader Bill Frist, Tennessee Republican, urged the CBO to focus “almost exclusively” on the matter until it is done.

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