- The Washington Times - Friday, October 24, 2003

The House Republican in charge of crafting the Medicare prescription drug plan hinted yesterday there may be new ways to resolve a key disagreement between the House and Senate bills.

Rep. Bill Thomas, the California Republican leading the Medicare negotiation team, said the final bill doesn’t have to include the exact competition provision included in the House-passed Medicare bill.

The House provision known as “premium support” requires the traditional Medicare plan to compete against private plans beginning in 2010. House conservatives insist this provision remain in the final bill, saying it will force Medicare to modernize and keep costs under control.

Senate Democrats say the provision will ruin Medicare, and have threatened to filibuster any final bill that contains it. Many say this is the key sticking point that could derail the bill.

Mr. Thomas said the final bill will hold down costs and change the system — the key goal of House conservatives — or it cannot pass the House. But he added this doesn’t necessarily mean the exact House 2010 provision, and he floated a new idea for keeping program costs down, which he called “comparative cost adjustment,” without giving details.

He dismissed the Senate Democrats’ contention that Republicans are trying to ruin Medicare by insisting on cost control and other reforms. It is pointless to create a costly new prescription drug plan, he said, without fixing the current system, which is on a path to bankruptcy.

“The current system is not sustainable,” he said. “We cannot discuss adding $400 billion to a system that is not sustainable.”

Mr. Thomas said the House 2010 competition provision is still on the table.

When asked how far he is willing to go to compromise, he said, “What it takes for me to get a ‘yes’ that I can live with and deliver back to the House.”

Rep. Michael Bilirakis, a Florida Republican and fellow Medicare negotiator, predicted the final bill probably won’t contain the 2010 competition and it is “more likely that efforts will be made to come up with something similar.”

Top Senate Democratic negotiator Max Baucus of Montana wants the 2010 competition provision dropped.

“I think it has to be for there to be a bill,” he said.

Though this issue remains a real challenge, negotiators made substantial progress yesterday deciding several other parts of the bill, Iowa Republican Sen. Charles E. Grassley said, though he declined to give details. Mr. Thomas said they hope to complete the bill by the middle of next week.

Mr. Baucus and Mr. Bilirakis, both said it was decided yesterday that there would definitely be a federally guaranteed “fallback” prescription drug plan for seniors if more than one private health plan isn’t available — a key request of Senate Democrats.

Negotiators also made a decision about what the drug benefit will actually look like, both said. Mr. Baucus said it is roughly what has been reported throughout last week, where seniors would pay roughly a $35 monthly premium and $275 annual deductible. In return, the government would pay 75 percent of their drug costs until about $2,200.

Seniors would be on their own until their out-of-pocket expenses reach about $3600, at which point the government would pick up 95 percent of “catastrophic” drug costs.

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