


WASHINGTON (AP) — The Senate gave final congressional approval Tuesday to the most sweeping changes to Medicare since its creation in 1965, including a new prescription drug benefit for 40 million older and disabled Americans. The 54-44 vote sends the bill to President Bush, who is eager to sign it into law.
Supporters said the $395 billion measure, which gives private insurers a large new role in health care for seniors, was a long overdue change for the 38-year-old Medicare program.
Drug coverage won’t begin until 2006, although seniors next year will be able to purchase a drug discount card that officials said could reduce their pharmacy bills by 15 to 25 percent.
Seniors “will finally have the prescription drug coverage they need and the choices they deserve,” Senate Majority Bill Frist of Tennessee said. “At the same time, it preserves traditional Medicare.”
Democratic opponents complained that the bill was a giveaway to insurers and drug companies. Sen. Edward M. Kennedy, D-Mass., said it will dump seniors “in the cold arms of the HMOs.”
While Frist and others called it a bipartisan vote, the tally fell largely along party lines. Forty-two Republicans, 11 Democrats and an independent backed the legislation. Nine conservative Republicans joined 35 Democrats in opposition.
The GOP-controlled House passed the bill near dawn on Saturday on a 220-215 vote, also split by party affiliation.
Senate Democratic leader Tom Daschle of South Dakota said Republicans would pay a price in coming elections because “seniors by an overwhelming margin oppose this legislation.”
Republicans relished their political triumph on an issue that Democrats have long exploited in political campaigns.
Bush sees signing the bill as fulfilling both his and many lawmakers’ campaign promises.
“Modernizing Medicare will make the system better and enable us to say to seniors we kept our promise,” Bush said after visiting Army troops Monday at Fort Carson, Colo.
When the legislation made it through the Senate for the first time, in June, Daschle and Kennedy were part of the overwhelming 76-21 vote for the bill. But in months of closed-door negotiations, majority Republicans and two Democratic senators forged a compromise bill that most Democrats believed was skewed to favor private insurers at the expense of traditional Medicare.
“It didn’t have to be this way,” Kennedy said.
At its heart, the Medicare legislation was designed as a grand bargain, with the new drug coverage for all Medicare beneficiaries long sought by Democrats combined with a Republican-backed plan to give private insurance companies a vast new role in health care for the program’s beneficiaries.
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