- The Washington Times - Tuesday, November 11, 2003

Republicans last night said they’re closing in on a final Medicare prescription-drug bill, and one important senator said House conservatives would get some version of all the key provisions they want.

Sen. Orrin G. Hatch, Utah Republican and Medicare bill negotiator, emerged from talks predicting the bill would be finalized today.

Democratic negotiators were more cautious.

“I think we’re close,” said Sen. John B. Breaux, Louisiana Democrat as he left the talks. He said there are “still some substantive issues we have to resolve.”

Democratic negotiator Sen. Max Baucus of Montana said “it’s getting there,” when asked if he could sign off on the bill as it is now.

The majority of the bill is agreed to, but several key issues have been holding it up.

Republican negotiators have pushed to include three provisions key to winning House conservatives’ support: requiring Medicare at some point to compete directly against private health plans, providing some sort of mechanism aimed at holding down Medicare costs if they get too high, and creating tax-preferred health savings accounts that encourage people to save for their medical costs.

Senate Democrats oppose all three, saying the provisions, especially direct competition, are designed to ruin Medicare. Mr. Breaux earlier yesterday said he has told negotiators, “There’s no way [the Senate] could accept all three of them.”

But Sen. Charles E. Grassley of Iowa, the top Senate Republican negotiator, last night said the final proposal will include some version of all three.

“I think that it includes all three,” he said, stressing that none of the negotiators have signed off on the bill yet and will meet again this morning. “There’s a consensus I share that it has to have some version of all three.”

Mr. Grassley would not give details last night about what the provisions look like, but earlier yesterday he said that in order to get a bill, House conservatives would either end up with all three of these provisions in weaker forms than they wanted, or they would get strong versions in two of these provisions and the third would be dropped.

He said Republican and Democratic negotiators have had all possible discussions and final decisions would be made today.

Negotiators have already agreed on matters such as the basic structure of the drug benefit, requiring wealthier seniors to pay more for doctor visits under Medicare and providing a government-guaranteed fallback plan for seniors if there are not at least two private drug plans available in their area.

House Speaker J. Dennis Hastert, Illinois Republican, and House Majority Leader Tom DeLay, Texas Republican, were expected to return to town today even though the House is not in session this week.

But Senate Minority Leader Tom Daschle, South Dakota Democrat, said yesterday the chance of getting a Medicare prescription-drug bill completed this year is “far less than 50-50.”

A Senate Republican aide said that the lead House Republican negotiator, Rep. Bill Thomas of California, on Monday stressed that health savings accounts must be in the final bill and pitched a new idea that linked the direct competition and cost-containment issues.

Under that proposal, the aide said, if the new drug benefit exceeds its budgeted cost of $400 billion over 10 years, a trigger would kick in. The president and Congress would have authority to examine the cost issue, and the direct competition between Medicare and private health plans would begin in some regions of the country.

Senate Republican aides confirmed that the drug benefit is essentially what has been reported previously: seniors would pay 25 percent of their annual drug costs up to roughly $2,200, then they’d be on their own until their out-of-pocket costs reach $3,600, after which point catastrophic coverage would kick in and the government would pay 95 percent of their drug costs.

They stressed, however, that those numbers are subject to change as the Congressional Budget Office provides cost estimates.

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