Congress struggles with Medicare benefits
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President Bush makes remarks at a forum on senior medicare benefits in Orlando, Florida on Thursday.
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WASHINGTON (AP) -- Republican congressional leaders struggled Thursday to shelter their emerging Medicare prescription drug legislation from the rising opposition of Senate Democrats and the recalcitrance of a powerful GOP committee chairman.
"This program is untested. It's untried. ... It's playing roulette with the lives of senior citizens," said Sen. Edward M. Kennedy, D-Massachusetts, taking aim at a feature that would put traditional Medicare in direct competition with new private insurance plans beginning in 2010.
But if Democrats argued that the call for competition went too far, Rep. Bill Thomas, the lead House negotiator over months of negotiations, argued it didn't go far enough. "It's guaranteed not to work," he said of the plan, while one of its authors, Senate Majority Leader Bill Frist, R-Tennessee, stood by his side.
At its core, the emerging bill would provide seniors a prescription drug benefit beginning in 2006, at a cost of $35 a month. The low-income would receive subsidies to defray the cost. At the same time, the plan would encourage private insurance companies to offer coverage under preferred provider organizations for seniors willing to opt out of traditional Medicare.
While lawmakers clashed over one of the few remaining issue in dispute, President Bush said in Florida it was time for Congress to act "for today's seniors but also for tomorrow's retirees."
"Either we'll have more debate, more delay and more deadlock, or we'll make real progress" in the coming days, he added, urging his audience to bring pressure on lawmakers to send him legislation soon.
In his remarks, the president made no specific reference to the proposal brokered by Frist and Speaker Dennis Hastert and embraced thus far by only two Senate Democrats.
Despite the sharp rhetoric in the Capitol, GOP leadership aides said the legislation remained on track to be brought to a vote next week, and Democrats stopped short of threatening a filibuster that could delay or derail passage in the Senate.
In addition, sources familiar with negotiations said Republicans had agreed during the day to concessions to delay the beginning of their plan for competition, and to provide further protection against the type of premium increases that Kennedy and other critics forecast would spell the doom of Medicare.
Rather than start in 2007, the program would begin in 2010, these sources said. And instead of limiting premium increases to 10 percent annually for seniors remaining in traditional Medicare, the cap would be 5 percent. Unresolved was the number of recipients to be covered.
Already, the special interests were beginning to line up.
The American Hospital Association announced its support of the bill, pleasing Republicans.
GOP officials also said they expected to gain the approval of the politically influential AARP, although the group's chief executive suggested the plan for direct competition in four metropolitan areas and one region be scaled down. "That sounds big," William D. Novelli said in an interview, adding the issue was "an example of what others should negotiate."
Republicans argue that the new private health plans would help modernize Medicare and possibly give seniors access to benefits such as preventive health care that are not currently covered by the government-run program. At the same time, they hope it will slow the growth in the cost of the program.
Many Democrats are wary of such a large role for private companies, but have been willing to accept it as part of a grand bargain that also included Republican support for the new drug benefit.
But in months of closed-door talks, lawmakers were unable to bridge their differences over Republican demands for direct competition between the two forms of coverage -- the private and the public.
The plan blessed by Republicans Hastert and Frist called for a three-year program limited to four metropolitan areas and one additional region of the country where managed care already has 30 percent of its Medicare beneficiaries enrolled. The Department of Health and Human Services could approve a three-year extension of the program, but after that, it would expire without action by Congress.
But Sen. Olympia Snowe, R-Maine, circulated a letter criticizing the provision for competition and urging its removal from the measure.
"The likely result will be significant increases in traditional Medicare premiums for seniors living in the affected area and could destabilize the Medicare program for all seniors," said the letter, signed by 30 Democrats, seven Republicans and one independent.
Republican officials described Thomas, R-California, as angry that Hastert and Frist had gone around him in making their deal, and also as having concerns about the wisdom of the policy they had advanced. At one point, Thomas relayed word that he was leaving Washington for his home in California. He reconsidered, though, and reconvened a meeting of the core group of negotiators.
"It's like all negotiations. The Japanese have a saying: The last inch is darkness. We're in the dark," said Sen. Max Baucus, D-Montana, who on Wednesday had said he was inclined to support the GOP plan. Sen. John Breaux, D-Louisiana., also has expressed support.
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