The House Ways and Means Committee last night edged toward approval of prescription drug legislation and the Senate continued debating its own bill — both chambers contemplating the biggest changes to Medicare since the program was created in 1965.
Rep. Bill Thomas, California Republican and chairman of the committee, said the House bill he crafted would modernize Medicare and “provide all seniors who so choose, a prescription drug benefit.”
“This is going to serve our seniors well,” said Rep. Nancy L. Johnson, Connecticut Republican.
But committee progress was slow and Democrats complained about the bill.
“What we have before us is a rotten deal for seniors,” said Rep. Pete Stark, California Democrat. “It privatizes Medicare.”
The committee was expected to finish the bill late last night or early this morning, with a top panel aide saying the committee members would stay until it was done. Republicans spent the evening turning back Democratic efforts to change the bill substantially.
Rep. Benjamin L. Cardin, Maryland Democrat, offered a proposal that would have given seniors another option of a Medicare-run prescription drug plan with government-set benefits and premiums. It was defeated on a party-line vote of 23-15.
While the underlying bill would set benefits, it also would give private plans some flexibility to alter those numbers. Democrats do not like this and argued that seniors need a government-run, guaranteed drug plan as one of their options.
“You would have an assured premium payment for an assured benefit, and it would not change,” said Rep. Sander M. Levin, Michigan Democrat.
Mr. Thomas said that “the problem with this amendment is that in a very short order you will have a government-dictated program,” which he said is the reason that Medicare has had problems changing with the times.
The House Energy and Commerce Committee also began its debate on the bill yesterday but is expected to take three days to approve it.
The House and the Senate bills — each with projected costs of roughly $400 billion over 10 years — would offer similar prescription drug benefits starting in 2006, 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, to deliver comprehensive health coverage, including drug coverage and such extras as catastrophic coverage and preventative care. Both bills also would give low-income seniors a good deal of extra help with drug costs.
The House bill, however, would go further — requiring traditional Medicare to compete against the private plans starting in 2010. Mr. Thomas modified it slightly, phasing it in over five years and establishing some controls so that Medicare premiums would not skyrocket.
The Ways and Means Committee last night defeated on a party-line vote a proposal by Rep. Jim McDermott, Washington Democrat, that would have eliminated the bill’s competition provisions.
But House Democrats criticized the proposal. The top Democrat on the Ways and Means Committee, Rep. Charles B. Rangel of New York, said it will be the “end of Medicare as we know it.”
He said private plans will market themselves to healthier seniors, leaving the sickest in traditional Medicare, which will drive up the cost of the program and make it a less viable option.
House Majority Leader Tom DeLay, Texas Republican, said yesterday that competition will drive down the cost of senior health care and that Democrats are trying to scare seniors, which “isn’t going to work.”
Under the bill, seniors would pay $250 annually and then 20 percent of their drug costs up to $2,000. They would then be on their own with drug bills until their total out-of-pocket spending reached $3,500, at which point the government would pick up the full tab, except for those with incomes of $60,000 or greater, who would have to pay some costs. The average monthly premium is estimated to be about $35.
Meanwhile, a group of Republicans on the House Energy and Commerce Committee are pushing their own drug plan. They have been negotiating with Republican leaders, and a committee spokesman said yesterday that a “tentative agreement” was reached on language to be incorporated into the bill, and committee Chairman Billy Tauzin, Louisiana Republican, said he is confident he has the votes to move the bill out of committee.