- The Washington Times - Wednesday, June 11, 2003

CHICAGO — President Bush yesterday urged Congress to pass a Medicare reform bill before July Fourth, saying America has “an unprecedented opportunity to give America’s seniors an up-to-date Medicare system that includes more choices and better benefits, like prescription drug coverage.”

Turning his focus from the Middle East to his domestic agenda, the president sought to push the Senate to complete work on the largest overhaul of the federal health care system for seniors in nearly 40 years.

“Medicine is changing; Medicare is not,” and its failure to keep up with medical advances is endangering seniors, Mr. Bush told 1,200 physicians and senior citizens gathered at the Hilton Hotel ballroom for an event held by the Illinois State Medical Society.

A Senate committee is set to vote on a bipartisan bill — with a price tag of about $400 billion over the next decade — as early as today and sponsors have expressed confidence the measure will pass. Debate would follow in the full Senate during the last two weeks of the month.

While Senate Minority Leader Tom Daschle, South Dakota Democrat, said the bill does not go far enough, he predicted that “it will pass.”

The House, meanwhile, is also moving ahead with its own bill — similar to the Senate measure but with a “means test” that would force higher-income seniors to pay more of their prescription medicine costs. Republican leaders say they will move on it quickly.

While both chambers could vote before the July Fourth congressional recess, ironing out differences between the two bills could take much of the summer.

“The Republicans … and the White House are unraveling Medicare; that’s what their goal is,” House Minority Leader Nancy Pelosi, California Democrat, said yesterday.

Mr. Bush, just back from a Middle East peace summit in Jordan, told Republican leaders at a White House meeting Tuesday that revamping Medicare is his top priority. The move comes as both political parties gear up for the 2004 election, in which seniors will play a large role in pivotal states such as Florida, Michigan and Illinois.

The administration wants to allow seniors the right to enroll in Preferred Provider Organizations (PPOs) and receive the same benefits offered to members of Congress.

But Sen. Kent Conrad, North Dakota Democrat, pointed out that to truly give seniors a level of coverage matching federal employees’ would cost about $800 billion — twice the level proposed.

Both the House and the Senate bills would give an equal level of drug coverage to seniors who stay in traditional Medicare as to those who choose a new Medicare option that would use private health insurance plans, like PPOs, to deliver comprehensive health coverage.

The White House and some congressional Republicans still prefer that there be a more robust drug benefit under the private plans, in order to attract seniors there.

Conservatives in today’s Finance Committee meeting will try to amend the bill to do this and other things to make the PPOs more attractive to seniors, said Finance Committee member Sen. Craig Thomas, Wyoming Republican.

Under both bills, seniors who opt to stay in traditional Medicare would have access to private drug-only plans. If those plans were not willing to offer coverage in some parts of the country, the government would step in.

The Senate proposal, offered by Senate Finance Committee Chairman Charles E. Grassley, Iowa Republican and co-sponsored by Sen. Max Baucus, Montana Democrat, would start in 2006.

Under that plan, seniors would pay a monthly premium of about $35; the first $275 in drug costs; half the bills between $276 and $3,450; everything between $3,450 and $5,300; and 10 percent of costs over that amount. Insurance would pay the remainder. Mr. Grassley and Mr. Baucus are retooling the bill slightly in order to close the coverage gap a bit.

Low-income seniors would receive government subsidies.

The Senate plan also would require Medicare recipients to pay a higher deductible for doctor services, $125, up from $100, beginning Jan. 1, 2006, with future rises tied to inflation.

The House proposal, meanwhile, would introduce “means testing” into a program that historically has offered a standard benefit regardless of income.

Under that version’s drug coverage, seniors would pay a $250 deductible, 20 percent of drug costs up to $2,000, then all the costs until out-of-pocket expenses reached $3,700 a year, congressional aides said. Insurance would cover all costs above that, and the remainder below.

The $3,700 cap on out-of-pocket expenses would rise for seniors with incomes over $60,000.

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