- The Washington Times - Monday, June 16, 2003

The effort to create a Medicare prescription-drug benefit for seniors is well under way in Congress, with the Senate beginning floor debate on its bill today and the House starting committee action on its bill tomorrow.

Some lawmakers predict the legislation will become law this year.

“I think it will get through both of them, House, Senate and conference, and make it to the president,” said Sen. Jim Bunning, Kentucky Republican, who voted for the Senate bill in the Finance Committee on Thursday.

The Senate bill has bipartisan support, with a 16-5 Finance Committee vote. Even a few Democratic critics — notably Minority Leader Tom Daschle of South Dakota — voted for the bill. But Mr. Daschle stressed that the measure must be improved on the floor.

Finance Committee Chairman Charles E. Grassley, Iowa Republican — who crafted the bill with Sen. Max Baucus of Montana, ranking Democrat on the Finance Committee — would not declare victory, but said, “we’re in a good position.” The president would like a bill by the July Fourth recess.

Both the House and Senate bills, which cost roughly $400 billion over 10 years, would offer similar prescription-drug benefits either through private drug-only plans for those who choose to stay in traditional Medicare, or through a new Medicare option.

The new option would use private health groups, such as preferred provider organizations (PPOs), to deliver comprehensive health coverage, including drug coverage and extras such as catastrophic coverage and preventive care.

Both parties, however, have concern. Mr. Grassley and Mr. Baucus were working over the weekend to pare down the number of potential floor amendments.

Democrats generally complain that the bill’s drug benefit is inadequate and the new setup will undermine traditional Medicare and steer seniors toward private plans. Some conservative Republicans, meanwhile, fear Congress is setting up a Medicare program that will cost the government too much money.

They say they would like to see more incentives for seniors to move to the private PPO setup. Republican Sens. Don Nickles of Oklahoma and Trent Lott of Mississippi voted against the bill in the Finance Committee.

Mr. Grassley says he has “a lot of work to do within my own Republican caucus” to garner support for the bill.

On the Senate floor, Republicans probably will pursue efforts to strengthen the bill’s PPO language. Sen. Jon Kyl, Arizona Republican, said one way is by allowing private plans more flexibility in bidding for the government contracts to provide the drug benefits.

Mr. Kyl and other Republicans complain the bill would set a ceiling on bids. “The more you ratchet down their flexibility, the less likely they are to succeed,” he said of the private plans.

Democrats probably will seek to add more money to the drug benefit and make sure there are clearly defined, mandated benefits. The bill would give private plans some flexibility on drug benefits, and Democrats are upset that seniors’ monthly premiums could vary across geographical regions.

Sen. Jeff Bingaman, New Mexico Democrat, said Democrats will seek ways to ensure there is “more predictability in the program.”

Democrats also want to make sure employers won’t drop retirees’ health benefits. A Senate Democratic aide said such a provision is key.

Democrats also want to eliminate any requirement that seniors use private plans for drug coverage. They may try to provide a more Medicare-controlled program.

A key difference in the House bill, set to be considered by both the Ways and Means and Energy and Commerce committees this week, is that it would make more reforms to Medicare — eventually requiring traditional Medicare to compete against the private plans.

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