MEDICARE REFORM: Breaux Urges Review Of Near Elderly Plan

      Sen. John Breaux (D-LA), chair of the National Bipartisan Commission on the Future of Medicare, yesterday entreated Congress not to act on President Clinton's proposal to expand Medicare to the near elderly until the commission has time to study the proposal's likely impact. "Congress created the commission, and the commission is specifically required to look at this question. Why don't we wait for the commission?," said Breaux in an interview. The New York Times notes that Breaux's recommendation "dims the prospects for congressional approval of the plan before this year's midterm elections." Despite Breaux's reservations, Clinton administration officials "said they would press for a vote on the proposal before the elections, so they could make an issue of it." Congressional Democrats concurred, saying "they believed that the expansion of Medicare would meet a genuine need, and that a vote this year would work to their political advantage." The Times notes that Republican leaders "had already expressed opposition to" the near elderly plan.

Let Us Do Our Job
      Breaux said, "The Medicare buy-in is not so urgent that we have to legislate in the last few months of this session, right before the election. The issue would become a political football, and that will not produce the best substantive result." Expressing a desire to "take the politics out of Medicare," Breaux urged Congress not to take any action until the Medicare commission hands its full report to the president in March 1999. He said, "I want us to produce a document that can become law. I don't want to produce a report that gathers dust in a library."

Take A Vote
      Under Clinton's Medicare expansion proposal, near elderly persons ages 55-64 would be able to buy into Medicare for about $300 to $400 a month. While Clinton maintains his proposal will "pay for itself," Republicans are dubious, contending that the proposal "could undermine [Medicare's] shaky financial condition." Administration senior advisor Rahm Emanuel said, "[W]e're determined to make [the Republicans] take a vote on it this year." And Health Care Financing Administration head Nancy-Ann Min DeParle, said, "We will work with Congress to get it enacted this year."

On The Commission's Agenda
      How Clinton's buy-in measure would impact Medicare's solvency is the primary issue Breaux wants his panel to scrutinize, the Times reports. Other options the commission is expected to consider include "proposals to increase the Medicare eligibility age, to charge higher premiums to affluent beneficiaries, to establish a copayment for home health services, to raise payroll taxes and to increase the use of medical savings accounts" (Pear, 3/3).

Medicare Wonder Boy
      Bobby Jindal, the new staff director of the bipartisan Medicare reform commission, is profiled by the Associated Press today. Jindal "acknowledges that Medicare ... has bigger problems barely dented by the most obvious solutions," such as antifraud efforts and provider payment cuts. But he remains "optimistic." He said, "So many times it's easy to say health care will grow by 10% a year and there's nothing we can do about it unless we cut rates or raise taxes. I think we need to reexamine those assumptions" (Love, AP/Los Angeles Times, 3/3).

The Tobacco-Medicare Link
      Senate Budget Chair Pete Domenici (R-NM) yesterday said Medicare was one program "budget writers must concentrate on saving." Speaking before the National Association of Counties, Domenici outlined budget recommendations for Congress, including using "any funds from a tobacco settlement ... to help reform and save Medicare." "There is more (of a) relationship between Medicare and tobacco than anything else," Domenici said (CongressDaily, 3/2).