Debate Over Medicare Prescription Drug Benefit Bill To Begin This Week
President Bush and congressional Republican leaders this week are expected to begin an "intensive drive" to add a prescription drug benefit to Medicare, the AP/Long Island Newsday reports (Espo, AP/Long Island Newsday, 6/2). Although formal committee action is not expected until next week, leaders from both houses will begin finalizing proposals in an effort to meet their goal of enacting a Medicare drug bill by the end of the month, CongressDaily/AM reports (Heil et al., CongressDaily/AM, 6/2). Senate Majority Leader Bill Frist (R-Tenn.) has said that the Senate will pass a prescription drug benefit bill by the July 4 recess (Holland, Albany Times Union, 6/1). Senate leaders expect the Senate Finance Committee to discuss drug benefit proposals this week, with markup beginning June 9 and floor debate the last two weeks of June, according to CongressDaily (Heil, CongressDaily, 5/30). President Bush has sent Republican legislators in the House and Senate a videotape urging them to take action on Medicare reform. "My goal is to give seniors more choices and better benefits under Medicare including a long-awaited prescription drug benefit," Bush says in the video. According to Roll Call, the video "exemplifies the importance" of a Medicare prescription drug benefit. "[N]ext to the economy, I can't think of an issue that is more important" than a drug benefit, a Republican leadership aide said (Preston/Kane, Roll Call, 6/2).
Although details the proposals have not been released, they are all expected to include elements of President Bush's plan (Rich/Heil, CongressDaily/AM, 6/2). Under Bush's Medicare reform framework, seniors would receive a choice of three coverage options beginning in 2006. First, seniors could remain in traditional fee-for-service Medicare, with access to prescription drug discount cards and catastrophic protection. Second, beneficiaries could enroll in "Enhanced Medicare," which would offer a choice of private plans that include prescription drug coverage. The third option, "Medicare Advantage," would be similar to the current Medicare+Choice program, which offers a selection of private health plans with and without prescription drug coverage. Low-income beneficiaries would receive additional premium and cost-sharing assistance. In the interim, all seniors would get immediate access to drug discount cards and protection against high out of pocket costs (California Healthline, 5/21). According to CongressDaily/AM, legislators in the Senate are basing their plan on the "tripartisan" prescription drug bill from last year (Heil et al., CongressDaily/AM, 6/2). That bill -- sponsored by Sens. Charles Grassley (R-Iowa), Orrin Hatch (R-Utah), Olympia Snowe (R-Maine), John Breaux (D-La.) and James Jeffords (I-Vt.) -- would cost about $370 billion over 10 years. Under the legislation, Medicare beneficiaries would have to pay a $24 monthly premium and a $250 annual deductible, after which the federal government would cover 50% of their annual prescription drug costs up to $3,450. After Medicare beneficiaries spent $3,700 out-of-pocket, the government would cover 90% of their annual prescription drug costs (California Healthline, 11/18/02) Meanwhile, the House is expected to adopt legislation similar to the version it passed last year, CongressDaily/AM reports (Heil et al., CongressDaily/AM, 6/2). Last June, the House approved a GOP-backed $350 billion Medicare reform bill (HR 4954) that would have given subsidies to Medicare beneficiaries to purchase drug coverage directly from private insurance companies (California Healthline, 5/28). In addition, a proposal by a group of House Energy and Commerce Committee members would offer Medicare beneficiaries a drug card that would work as a debit card to purchase prescription drugs, the AP/Newsday reports. Under the plan, beneficiaries would purchase the card for $30 per year and would be given a fixed amount of money to purchase drugs, based on income. Beneficiaries at or below the federal poverty level would receive unlimited funds while beneficiaries whose incomes were above $22,450 would receive about $100 per year (AP/Long Island Newsday, 6/2).
In related news, House Ways and Means Health Subcommittee Chair Nancy Johnson (R-Conn.) has proposed that Medicare develop a coordinated care and disease management program for beneficiaries, CongressDaily/AM reports. Under the program, health officials would ensure that Medicare beneficiaries are taking needed medications, that all beneficiaries' physicians are in contact with each other to avoid drug complications or misguided treatment and that beneficiaries go to all appointments they should to maintain their health. According to advocates, such steps can reduce illness, hospitalizations and dangerous drug interactions and save money by avoiding hospital stays and other costly treatments. Johnson said her proposal would cover beneficiaries in the traditional fee-for-service Medicare and in Medicare+Choice plans (Rich/Heil, CongressDaily/AM, 6/2).
Using the Federal Employees Health Benefits Plan as a model for Medicare reform might not be as effective as expected, according to a study released Friday, CongressDaily reports. Speaking at a Kaiser Family Foundation briefing, policy analyst Mark Merlis, the study's author, said, "FEHBP, like any private plan, costs more than Medicare." In addition, Merlis said making private coverage available, particularly in rural areas, would be a challenge. Merlis said, "It's not easy to put together multiple competing networks that would be national in scope." Stuart Butler, of the Heritage Foundation, which supports modeling Medicare after FEHBP, disagreed with Merlis' findings and said that Medicare's lack of a drug benefit or a cap on out-of-pocket spending illustrates the "difficulties of developing a government-run system" (Rovner, CongressDaily, 5/30).
Meanwhile, the New York Times today profiles Sen. Chair Charles Grassley (R-Iowa), chair of the Senate Finance Committee, which has jurisdiction over Medicare. According to the Times, Grassley, a farmer, could "make life complicated" for the Bush administration and supporters of privatizing Medicare. Grassley, who plans to "look after the interests of ... beneficiaries in places like Iowa," favors raising Medicare reimbursement rates for doctors and hospitals in rural areas and preserving seniors' access to the traditional Medicare program while adding a prescription drug benefit, according to the Times (Toner, New York Times, 6/2).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.