MEDICARE REFORM: Panel Hung Up on Key Details
The National Bipartisan Commission on the Future of Medicare appears to be moving toward recommending a premium-support program, but the consensus remains "fragile," the New York Times reports. After a day of debate described as "vehement" but "civil," two key sticking points remain in the effort to secure the needed 11 votes for the 17-member panel to finalize a recommendation (Pear, 1/27). The points of contention are whether or not to add prescription drug coverage to the basic Medicare benefits package and whether that basic benefits package should be defined, CongressDaily reports. Two presidential appointees on the panel, Stuart Altman and Laura Tyson, have made it clear that they will only support the premium-support proposal if it includes drug benefits (Rovner, 1/26). Tyson, currently dean of the University of California- Berkeley's Haas School of Business, said, "It could deadlock because of the drug coverage questions -- this is the pivotal issue." Similarly, commission member Rep. Jim McDermott (D-WA) "estimated that the [premium-support] proposal would result in a 30% increase in the premium cost to beneficiaries" and said that drug coverage must be included to justify that increase (Rubin, Los Angeles Times, 1/27).
That deadlock could very well happen: co-chair Rep. Bill Thomas (R-CA) said "if members push for inclusion of drug coverage in the traditional Medicare package, 'it's going to be difficult to come to an agreement'" (CongressDaily, 1/26).
What's The Rush?
Panel members also sparred yesterday on whether the March 1 deadline for a final recommendation should be set in stone. Although Altman, backed by Tyson, said, "I don't know why the March 1 deadline is so important," Thomas said, "Any attempt to extend the time will just get us deeper into the session" (Rovner, CongressDaily/A.M., 1/27).
Co-chair Sen John Breaux's (D-LA) proposal would have the government pay for "88% of the national average cost of a health care plan," with a means-testing provision that would lower the government's contribution to 75% for households earning more than $50,000 a year, and increasing it to 100% for the poor (Los Angeles Times, 1/27). Former HCFA Administrator Bruce Vladeck, who has signaled he will not sign on to the premium- support plan, questioned how the proposal would save the financially teetering Medicare program, saying the Breaux plan assumes the "private sector will have some wonderful mechanism, which I don't quite understand, to save money" (New York Times 1/27).
Don't Forget Long Term Care
In a release, the American Health Care Association said yesterday that the commission "will fail in its goal of providing security to our nation's seniors through Medicare if the panel's final report does not address long term care." AHCA President Paul Willging said "one of Medicare's inadequacies is that the program covers only very short stays in a nursing home." He called on Congress and the White House to "eliminate requirements capping payment for therapy," fund the prospective payment system and eventually overhaul the entire long term care system to prepare for the needs of "77 million aging Baby Boomers" (1/27).