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Dingell in middle of Medicare overhaul
It may take lawmakers till Christmas to
reach a deal
BY RUBY L. BAILEY WASHINGTON -- Nearly 40 years after he witnessed the creation of
Medicare, U.S. Rep. John Dingell is among 17 people who must somehow agree
on a plan to expand it -- a plan that will satisfy liberals and
conservatives and assist cash-strapped seniors with escalating prescription
drug costs. Getting that plan won't come easy. It could take several more
months to hammer out. Dingell, a Dearborn Democrat, was present in 1965 when President
Lyndon B. Johnson signed Medicare into law. After Dingell's decades in
Congress, he's considered a master at negotiations. But even he ranks the
House-Senate conference committee's assignment as "trying to square a
circle." The group, with eight representatives and nine senators, has a
Republican majority. The members met for a second time Thursday, agreeing on
legislation that would alter contracts with providers, among other things. But they have yet to deal with the most complicated issues in the
proposed Medicare overhaul. Before the committee are two bills -- one 700 pages long, the other
1,000 pages -- both purporting to offer the best plan for senior citizens
seeking prescription drug relief and the ability to shore up Medicare's
finances. The bills would provide the first subsidies for prescription drugs
since the program's creation. The committee's job is to turn them into one proposal that can get
bipartisan support when it again faces a Congress divided on the issue along
party lines. Democrats, who have called the current House bill a time bomb
that will end the guarantee of affordable coverage under Medicare, want to
preserve the entitlement, while Republicans call for increasing the role of
private insurance companies to help ensure Medicare's financial future. "It's going to be an enormously difficult conference, given
the cast of characters and given the views of my Republican
colleagues," Dingell said. The committee includes Rep. Bill Thomas, R-Calif., who has called
Medicare an "out-of-date" program and said Democrats "would
rather scare seniors and ignore their true needs," according to news
reports right after the House battle in late June, when the
Republican-produced measure narrowly passed. Adding to the fodder, the Congressional Budget Office told
lawmakers last week the legislation is unlikely to prompt older Americans to
sign up for private health plans and that the bills would likely exceed the
$400-billion limit agreed to by lawmakers. And the AARP, the nation's largest organization of seniors, is
threatening to oppose the measure. Pressure from the group's lobby and fear
of its 35 million members could make legislators rethink their votes. Earlier this month, Democrats held town hall meetings across the
country, including Michigan, where they heard an earful from confused,
frustrated seniors staring at mounting prescription drug bills and wondering
whether they'll see any relief in 2006, when the drug benefit is to kick in.
On Friday, the House passed a measure that would allow lower-cost
drugs to be imported from Canada and some other countries. The Medicare
bills under negotiation would allow imports only from Canada. Meanwhile, President George W. Bush, seeking to head off a battle
that ends with a Medicare bill that wouldn't be able to gain bipartisan
support, met with the committee last week. Dingell said it was a generally
friendly gathering. Bush had promised in 2000 to push for prescription drug relief for
seniors, and the issue is expected to be a major campaign topic in 2004.
"The president wants the bill," said Tom Miller, director of
health policy studies at the Cato Institute, a public policy research group
in Washington, D.C. "At the end of the day, he probably doesn't want to
come up empty in 2004." In June, both chambers passed legislation that would create both a
drug benefit and a large new role for private health plans in Medicare,
which serves about 40 million Americans. Both bills would require seniors to
pay a monthly premium and a yearly deductible before receiving assistance
for medicines. Among the issues remaining to be worked out is the provision that
would allow competition between the Medicare program and private health
plans in 2010. Dingell and other Democrats say they fear that would
ultimately turn Medicare over to private insurance. "What they will do, in 2010, is give a voucher to everybody
and say, go out and get a health care plan from the private companies or
Social Security Administration, which administers Medicare,"
Dingell said. The conference committee's legislative staff will work during the
August congressional break, and legislators are expected to try to complete
negotiations in mid-September. But Miller and others say negotiations may last until Christmas.
And the final report could then face battles in Congress. "Depending on what type of conference report they write,
they'll have trouble in the Senate or they'll have trouble in the
House," Miller said. John Rother, AARP's policy director, said his group opposes the
Republican-written House bill. The group is concerned that the drug benefit
would require substantial payments by seniors and worries that either bill
could encourage employers to drop drug coverage to retired workers. "Ultimately, I'm optimistic we'll get a bill," Rother
said. "What's at stake is how good will the bill be?" Copyright ©
2002 Global Action on Aging
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