Congress Returns, Work on Reconciling House and Senate Medicare Bills Continues
Although international issues such as rebuilding Iraq might "overshadow" discussion of some domestic issues, a Medicare prescription drug benefit is likely to be one of the two "marquee ... issues" Congress considers as it returns today from its August recess, the New York Times reports (Gay Stolberg, New York Times, 9/2). House and Senate negotiators began to reconcile the two chambers' Medicare bills (HR 1 and S 1) before the August recess, according to the Washington Post (Dewar/Eilperin, Washington Post, 9/2). Aides to conference committee members have reached tentative agreements on about 200 pages of legislative text from the 747 pages in the House bill and 1,044 pages in the Senate proposal, the Wall Street Journal reports. CMS Administrator Tom Scully has said that the chances of a final agreement are "very high" (Rogers/Lueck, Wall Street Journal, 9/2). But negotiations have "moved slowly" and lawmakers have not yet begun discussing some of the "most contentious issues," including a House bill provision that would require traditional, fee-for-service Medicare to begin competing directly with private plans in 2010, the Post reports (Washington Post, 9/2). Some lawmakers have begun to show concern that the negotiations have become "so delicate ... they might fall apart," the Times reports (New York Times, 9/2). House and Senate negotiators "must balance ... sometimes conflicting goals": passing a final bill that provides a drug benefit generous enough that it "satisf[ies]" beneficiaries and also includes enough incentives for private health plans to participate, the Journal reports (Wall Street Journal, 9/2).
Some members of Congress, including Sen. Edward Kennedy (D-Mass.), have said that President Bush must "intervene strenuously" in negotiations so that lawmakers produce a bill both chambers will approve, the Post reports. "The president is going to [have to] use some of his political capital," Rep. Deborah Pryce (R-Ohio), head of the House GOP conference, said (Washington Post, 9/2). However, getting involved in Medicare negotiations "could be dicey" for the president because he could be forced to oppose House conservatives to produce a bill acceptable to the Senate, the Journal reports (Wall Street Journal, 9/2). Kennedy said, "Unless the president is prepared to stand down his right wing, we won't get a bill. The only way we can get a bill is if it is bipartisan."
Many lawmakers believe that the chances of passing a Medicare bill will "rapidly diminish" once the 2004 presidential campaign ramps up, further intensifying pressure on negotiators, the Los Angeles Times reports (Hook, Los Angeles Times, 9/1). Senate Majority Leader Bill Frist (R-Tenn.) has said he wants a final bill by the end of September, before the presidential campaign begins in earnest. In addition, Sen. Mitch McConnell (R-Ky.), the Senate Majority whip, said, "Everybody assumes the longer we go on, the more partisan it becomes, the less likely we are to achieve things" (New York Times, 9/2). Senate Finance Committee Chair Charles Grassley (R-Iowa) recently said, "I think the president ought to get the leaders together and say, 'Why can't we get this done by Oct. 12th?'" (Wall Street Journal, 9/2).
A Medicare drug benefit is most needed in rural areas where beneficiaries are two times more likely to lack drug coverage than urban beneficiaries, according to a report by the think tank Center for American Progress, the AP/Philadelphia Inquirer reports. The report by CAP -- whose president and founder is John Podesta, former chief of staff for President Clinton -- says that fewer Medicare beneficiaries in rural areas have private drug coverage or coverage provided by former employers than their urban counterparts. Further, the report says that beneficiaries in rural areas pay about 25% more for prescription drugs than beneficiaries residing in cities. The report recommends keeping a provision in the House Medicare bill that would extend a Medicare drug benefit to beneficiaries who are also eligible for Medicaid; enacting a "stable system" to administer the drug benefit in rural areas; "at a minimum," keeping Senate provisions that would create a government drug benefit plan in areas where no private insurers participate; and allocating spending so that rural beneficiaries do not pay higher costs to subsidize private health plans in urban areas (Sullivan, AP/Philadelphia Inquirer, 9/2).
Planning to "redoubl[e] its effort" to encourage Congress to pass a Medicare bill by the end of the year, AARP on Friday is scheduled to host a rally on Capitol Hill and deliver 100,000 petitions to lawmakers, the Washington Times reports. In addition, thousands of AARP members on Friday plan to call lawmakers to discuss the proposed legislation. Group leaders are concerned that Medicare reform negotiations are "stalling," with the bills facing criticism from both liberals and conservatives, the Times reports. AARP spokesperson Steve Hahn said, "We want to rebuild momentum so they can pass legislation this year" (Fagan, Washington Times, 9/2).
The Washington Post on Aug. 31 profiles members of Congress who during the August recess tried to "sell their [party's] version" of Medicare reform. About 40 House Democrats, 24 House Republicans and several senators in both parties held sessions in their home states during August to discuss Medicare reform proposals, according to the Post (Goldstein, Washington Post, 8/31). NPR's "Morning Edition" today reports on Medicare beneficiaries' reactions to congressional negotiations on reforming the program and adding a prescription drug benefit. The segment includes comments by Sen. Barbara Mikulski (D- M.D.) and Kaiser Family Foundation President and CEO Drew Altman (Rovner, "Morning Edition," NPR, 9/2). The segment is available online in RealPlayer.This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.