House Votes Down Means Testing Motion for Medicare Prescription Drug Benefit
The House on Tuesday voted 234-161 to reject a motion that would have asked negotiators charged with reconciling the House and Senate Medicare bills (HR 1 and S 1) to include means testing in the proposed prescription drug benefit, the Washington Times reports. The "symbolic" measure, proposed by Rep. Jeff Flake (R-Ariz.), would have asked negotiators to include in the final bill a provision that would require all beneficiaries with higher incomes to pay more out-of-pocket for access to a drug benefit, not just catastrophic coverage, the Times reports. The House-passed Medicare bill already includes a provision that would require beneficiaries with higher incomes to pay more out-of-pocket before catastrophic drug coverage took effect. Flake said the only way to control costs under the proposed drug benefit is to exclude beneficiaries with the highest incomes. "There is no reason in the world why we ought to be paying the prescription drug benefits for the wealthiest in society, the Bill Gates, the Barbra Streisands, the Ted Turners, the Warren Buffetts," he said.
A House Republican leadership aide said the House vote "sends a signal to conservatives that they have more work to do to convince the majority members in the House that this is a position worth fighting for." However, Jim Manley, a spokesperson for Sen. Edward Kennedy (D-Mass.), who has threatened to filibuster any final bill that includes means testing, said that 51 House Republicans voting against the measure indicates that there is a lack of support for some of the central reforms conservatives have asked for in a final bill, including means testing and a provision that would require fee-for-service Medicare to compete directly with private plans beginning in 2010. Manley said the vote "demonstrates that there is a will in the House for a bipartisan approach" to a final Medicare bill. House Republican leadership aides have said the failure of Flake's measure does not weaken the party's ability to push for means testing and that House Republicans will "continue fighting" for means testing provisions, the Times reports (Fagan, Washington Times, 10/9).
Although few outside observers believe that Medicare conferees can finish work on a final bill before an Oct. 17 deadline set by Republican leaders, negotiators have not yet abandoned their attempts to do so, CongressDaily/AM reports. After a meeting with Senate Majority Leader Bill Frist (R-Tenn.), House Speaker Dennis Hastert (R-Ill.), Rep. Billy Tauzin (R-La.) and Sen. Charles Grassley (R-Iowa), conference Chair Bill Thomas (R-Calif.) said, "It's not my deadline, but I'll work under it." Tauzin said that the meeting centered on process and that conferees would meet again Thursday via telephone. Thomas said negotiators on Thursday would "loop back through" some issues that have already been addressed in an attempt to finalize some decisions "so staff can draft over the weekend." Congressional staffers said that although several key issues have not been resolved, they are making progress on the drug benefit, how to structure and pay private plans and how to restructure some payments to providers. Maintaining the $400 billion cost of the legislation is still a "key challenge," according to conferees, CongressDaily/AM reports. "We have $400 billion and everyone has $600 billion worth of wishes," Thomas said (Rovner, CongressDaily/AM, 10/9).
Negotiators have reached tentative agreements on several provisions in a final Medicare bill that seemingly "rejec[t] major recommendations" made by the Bush administration, the AP/Ft. Lauderdale Sun-Sentinel reports. Under negotiators' agreements, private insurance companies that offer preferred provider plans under Medicare would be reimbursed based on a formula that considers both competitive bidding and the cost of traditional, fee-for-service Medicare. Bush administration officials proposed setting payments based only on competitive bidding. In addition, negotiators have agreed to allow any private company that wishes to provide coverage under Medicare to do so. The Bush administration had proposed allowing only three such plans to operate in each region. According to the AP/Sun-Sentinel, there has been no indication that administration officials have strongly objected to the negotiators' stances (Espo, AP/Ft. Lauderdale Sun-Sentinel, 10/8).
The Boston Globe on Thursday examined Medicare beneficiaries' desire to obtain specifics on Democratic presidential candidates' plans for Medicare. According to the Globe, many of the Democratic candidates have been "speaking in abstractions" about their plans to "save" Medicare and create a prescription drug benefit under the program. The Globe notes that such arguments may be "less persuasive, or relevant, than the day-to-day, dollars-and-cents anxieties" that worry many seniors (Healy, Boston Globe, 10/9).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.