Medicare drugs gain supporters Rx coverage moves toward Senate vote

WASHINGTON – The Senate Finance Committee reached for bipartisan passage Thursday of legislation providing prescription drug coverage under Medicare, part of the most far-reaching changes in the government’s health care program for seniors since its creation in 1965.

“Both parties have promised for years to add prescription drugs to Medicare,” said Sen. Charles Grassley, R-Iowa, as he gaveled the committee to order before rows of lobbyists. “Today we’re here to deliver.”

“We’re about to pass landmark legislation,” added Sen. Max Baucus of Montana, the senior Democrat on the committee and Grassley’s partner in crafting the bipartisan bill.

“The bottom line is, with the cost of prescription drugs having increased by 16 percent between 1999 and 2002 – a rate seven times higher than the rate of inflation, we are beyond any question of need,” said Sen. Olympia Snowe, R-Maine, another committee member who had a role in drafting the legislation.

The bill offers prescription drug benefits for the nation’s 40 million Medicare beneficiaries, with coverage to be offered through private insurance companies and financed in part through government subsidies. At the same time it provides for a new managed care option for seniors – preferred provider organizations – a step the Bush administration says would help modernize Medicare and shore up its long-term finances.

Despite criticism from some Democrats, committee approval was not in doubt and the bipartisan measure easily withstood a pair of early challenges. An attempt by Senate Democratic leader Tom Daschle of South Dakota to put a limit on premiums for drug coverage was rejected 14-7, and a proposal by Sen. Don Nickles, R-Okla., to remove a provision allowing states to give health coverage for legal immigrant children and pregnant women also fell, 13-8.

By midevening the Finance Committee voted 16-5 to recommend the bill to the Senate. This vote will clear the way for debate in the full Senate beginning Monday.

To ensure that private plans would be offered as fairly in rural parts of the country, Snowe also helped to include a provision in the bill requiring private insurers to bid regionally rather than state-by-state.

The regional requirement would give insurance providers the ability to “meld urban and rural areas” and spread out their costs, Snowe said. Committee members have expressed concern that not enough good data exists about whether private insurers would offer plans in rural areas they’re not now serving.

The finance committee met as House GOP leaders rolled out their own version of the legislation. Both bills carried price tags in the range of $400 billion over 10 years, and both would impose higher costs on seniors who remain in traditional Medicare, in part by raising deductible charges for doctor care and out-of-hospital services.

Despite criticism from some Democrats, committee approval was not in doubt, and Grassley pushed for a vote. That would clear the way for debate in the full Senate beginning Monday.

Majority Leader Bill Frist, R-Tenn., told reporters he was determined to pass the bill before lawmakers leave for a July 4 recess in two weeks, and added he hopes to have a final compromise on President Bush’s desk by the first week of August.

The committee worked as Bush campaigned for the second straight day for Congress to send him the legislation by July 4, a more ambitious timetable than the one Frist laid out.

“There’s story after story after story, all across America, about people wondering whether or not they can afford lifesaving drugs in their later years,” Bush said at New Britain General Hospital in Connecticut. “And the Congress must act, that’s what the Congress must do.”

By whatever timetable, the effort to approve legislation has taken on considerable momentum in recent days.

“This is the single biggest expansion of Medicare in its history,” Frist told reporters. And Bush’s plan for a bigger role for private insurance companies marked a major turn, as well, in a program conceived at the height of Lyndon Johnson’s Great Society more than three decades ago.

The House and Senate bills vary considerably in details, but at their core they are similar. Both cover a portion of seniors’ drug benefits and the proposed PPOs, which would offer preventive care as well as a cap on out-of-pocket health care costs.

Both would give private companies a stronger role in the government-run program, although the House proposal goes further, with proposals certain to stir controversy.

In addition to raising the deductible on so-called Medicare Part B, both bills would impose higher patient fees for some tests done in labs housed in doctors’ offices or hospitals.

Joel Kirkland of States News Service contributed to this report.