Friday, June 20, 2003

The Bush administration yesterday announced it will oppose a part of the Senate’s Medicare bill that reverses the 1996 welfare-reform legislation and allows Medicaid to cover legal immigrants who are pregnant women or children.

While otherwise encouraging the Senate bill, the administration said it didn’t want to overturn current policy, which prohibits federal Medicaid and State Child Health Insurance Program money to go to legal aliens.

“These provisions contradict current welfare-reform policy and should not be undone in Medicare-reform legislation,” the White House said in a statement of administration policy on the Senate bill. The administration issues these documents when major legislation is pending before Congress.

Sen. Bob Graham, Florida Democrat, had secured an amendment in the Finance Committee to reverse a 1996 welfare-reform provision that requires legal immigrants to have been in the United States for five years before they can be covered under federal funds from Medicaid and the State Child Health Insurance Program.

His proposal would allow states to cover legal immigrant children and pregnant women and to be reimbursed for the federal share of those costs.

About 20 states and the District use their own money to cover costs for pregnant women and children who are legal aliens.

Medicare overhaul bills are pending in both houses of Congress, and both chambers aim to pass a bill by the end of next week.

Republicans continued yesterday to turn back Democratic attempts to change the prescription-drug proposals that are at the center of both bills.

The House and Senate drug bills 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 option using private health groups like preferred-provider organizations, which would deliver comprehensive health coverage, including drug benefits.

The House bill would go further by requiring Medicare to compete with private plans starting in 2010.

The Senate yesterday accepted a bipartisan provision that would speed less-expensive generic drugs to the market by closing loopholes in current law that drug companies use to block generic drugs. It was approved, 94-1, with only Sen. Orrin G. Hatch, Utah Republican, voting no.

Other Senate amendments are pending, but bill co-sponsor Sen. Max Baucus, Montana Democrat, warned against too many changes, saying the bill is “somewhat tenuous.”

Some Republicans, though, have reservations about the bill as it stands now.

“I don’t think it’s the slam-dunk that some had portrayed,” said Sen. Jon Kyl of Arizona, who, along with other Republicans, wants to give private drug plans more freedom to bid for government contracts.

Also yesterday, Senate Minority Leader Tom Daschle, South Dakota Democrat, failed in an attempt to cap how much seniors would pay in monthly premiums under the Senate bill.

Democrats say the bill would give private drug plans flexibility in setting monthly premiums for coverage. Mr. Daschle said premiums could vary widely in different regions and a cap was needed to “give a little more certainty and little more stability to seniors.”

His proposal was defeated, 56-39.

Meanwhile, the House Energy and Commerce Committee was expected to pass the House bill late yesterday, after defeating numerous Democratic amendments, including one to strip the 2010 competition provision from the bill.

Panel Democrats yesterday held up a large cardboard gravestone that read “R.I.P. Medicare.”

As for the provision extending Medicaid to some legal immigrants, Democrats said they hope to keep it in the bill.

“I think that it’s very important for purposes both of fairness, as well as simplicity, to ensure that everyone is treated alike,” Mr. Daschle said. “Everyone who is legally residing in this country ought to have the same opportunity for benefits.”

But opponents say when legal immigrants come here it is with the understanding they not become wards of the state.

Sen. Don Nickles, Oklahoma Republican, said the change “just throws immigration policy on its head.” He expects the provision will be dropped when the House and Senate bills go to a conference committee to work out differences.

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