Medicare Negotiators Reach Tentative Agreement on Dual-Eligibles
A "core group" of the negotiators charged with reconciling the House and Senate Medicare bills (HR 1 and S 1) has tentatively agreed to provide a Medicare drug benefit to beneficiaries who are also eligible for Medicaid, the Wall Street Journal reports (Lueck, Wall Street Journal, 10/2). Conference committee member Sen. Don Nickles (R-Okla.) said of the proposal, "I think that was the direction" (Rovner, CongressDaily/AM, 10/2). The House Medicare bill would provide drug coverage to all of the estimated 40 million Medicare beneficiaries, with the federal government gradually assuming the drug costs of covering the so-called dual-eligibles over 15 years. Dual-eligibles would not receive drug coverage through Medicare under the Senate bill but rather would continue to receive it under Medicaid. The Bush administration reportedly told lawmakers earlier that it supports the Senate's position on dual-eligibles. The National Governors Association, AARP, Consumers Union and the Catholic Health Association have said they support the House provision. About 6.2 million people are enrolled in both Medicaid and Medicare, and another four million people are considered dually eligible but have not yet enrolled in both programs. Although states are not required to provide prescription drug benefits under Medicaid, all 50 states do so. Dual-eligibles make up 19% of all Medicaid beneficiaries, and states spend $7 billion per year to provide prescription drug coverage to such people (California Healthline, 9/24). Medicaid benefits vary from state to state and are subject to change depending on states' economic status, the AP/Las Vegas Sun reports. Sen. John Breaux (D-La.) said, "We want to have one [drug benefit] program. We don't want to have two separate programs" (Espo, AP/Las Vegas Sun, 10/1).
Although negotiators involved in the tentative agreement said that no decisions are final until a final bill is approved, the agreement could foster bipartisan support for a final bill. The tentative agreement also "signals a victory" for the House bill -- which is largely supported by Republicans -- and for Democrats, most of whom believe that low-income beneficiaries should receive the same benefits as those with higher incomes, according to the Journal. In addition, the agreement could be beneficial to states, which would receive some relief from rising drug costs under their Medicaid programs. However, the complete details of the agreement have not yet been decided. According to the Journal, negotiators still are considering ways that the federal government could receive some of the money that states would save if Medicare covered dual-eligibles' drug costs (Wall Street Journal, 10/2).
Senate Health, Education, Labor and Pensions Committee Chair Judd Gregg (R-N.H.) on Wednesday said he is "not optimistic" about the possibility of Congress' passing a final Medicare bill before the end of the current congressional session, CongressDaily reports. Speaking to the National Association of Manufacturers, Gregg said, "The chances are not high. [A Medicare bill] may end up getting completed next year." Gregg also said that neither the House nor Senate Medicare bill would do enough to control drug prices or initiate competition among private health plans (Rovner/Heil, CongressDaily, 10/1).
The Republican Main Street Partnership, a group of 53 Republican House members, nine senators and four governors, on Thursday will launch an advertising campaign to urge Congress to pass a Medicare prescription drug bill, USA Today reports. The advertisements will run in Washington, D.C., and state, "For years we promised to help our seniors. We cannot forget about them now." RMSP Executive Director Sarah Chamberlain Resnick said the group is running the campaign because it thinks a Medicare prescription drug benefit bill is "in jeopardy," which could complicate the re-election hopes of some Republicans. "It could flip the Senate (to Democratic control) just over this issue," Resnick said. The group is not endorsing a specific plan, according to USA Today. Resnick said that the group members maintain that any Medicare bill should provide drug coverage to seniors who currently lack it (Kiely, USA Today, 10/2).
The House Tuesday approved an extension of the Temporary Aid to Needy Families program, which includes a provision that would extend a program under which the federal government pays Medicare Part B premiums for low-income Medicare beneficiaries, CongressDaily reports (CongressDaily, 10/1). Under the QI-1 program, which the provision would extend for six months, the federal government pays Part B premiums for beneficiaries whose annual incomes are between 120% and 135% of the federal poverty level. The bill would be funded by a six-month extension of user fees for the U.S. Customs Service (California Healthline, 9/25). The House passed the bill last week, but had to revote Tuesday because the Senate added a temporary provision "equalizing urban and rural standardized payment amounts" under Medicare's hospital inpatient payment structure (CongressDaily, 10/1).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.