MEDICARE BUY-IN: Senate Dems May Use ‘Familiar Strategy’
Senate Democrats supportive of President Clinton's Medicare buy-in proposal "are planning a big push that, in many ways, resembles" the strategy they used to pass the 1996 Health Insurance Portability and Accountability Act, commonly referred to as the Kassebaum-Kennedy law. CongressDaily reports that Sen. Edward Kennedy (D-MA) and other top Democrats "will first try to move the bill through the Finance Committee," where primary sponsor Sen. Pat Moynihan (D-NY) is the ranking member. The Democratic senators "are expecting to have to force the issue by calling for a vote on the Senate floor each time a House bill comes up for a vote -- then fight it out in conference committee." Although the Medicare buy-in has no Republican supporters, one Democratic aide said the proposal "is so high in the polls that, in the end, it's irresistible." The Democratic senators will "keep offering it on the floor until (senators) can't stand the pressure anymore." CongressDaily reports that the Democrats will have to "swing" 15 Republicans to gain the estimated 60 votes needed to "invoke cloture" in the Senate (Serafini, 3/20).
The Council for Affordable Health Insurance said Friday it "strongly objects" to the buy-in proposal, which it says will cause payroll taxes to double and will "induce more people to retire at an earlier age," thus reducing the number of workers supporting each beneficiary, which would in turn cause payroll taxes to rise (CAHI release, 3/20). An editorial in the Lincoln Journal Star says Congress "should reject" the buy-in proposal because an "expansion of Medicare ... would increase the role of government in health care." The government's track record "does not encourage optimism that good things will result," the editorial says (3/19). While the buy-in proposal might be a "noble" intention, a San Jose Mercury News editorial says "it doesn't begin to address" the important issue of "whether, as the baby boomers begin to reach retirement age and beyond, there will be enough physicians trained in geriatric medicine to meet their needs" (3/22).
In other news reminiscent of Kassebaum-Kennedy, one of the options created by the 1996 law "is not as attractive as Congress had hoped." The Gannett News/Salt Lake Tribune reports medical savings accounts (MSAs), which "make it possible for qualified workers to put money into a special account and withdraw it at any time to pay health care costs," are much less popular than backers had hoped, largely because they are "confusing for the insurance agents who have to sell them and the potential buyers." Only 22,051 people have taken advantage of the 525,000 MSAs that officials thought would be purchased. "[A]bout 50% of why the participation has been low is lack of education," said Merrill Lynch & Co. financial consultant Rob Kennedy (3/22).