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Medicare drug bill could be tough sell { November 17 2003 } Original Source Link: (May no longer be active)    http://www.orlandosentinel.com/services/site/premium/access-registered.intercept http://www.orlandosentinel.com/services/site/premium/access-registered.intercept Medicare drug bill could be tough sell By Jill Zuckman Washington Bureau November 17, 2003 WASHINGTON -- Congressional leaders Sunday unveiled their sweeping plan to provide a Medicare prescription-drug benefit to 40 million senior citizens, and President Bush vowed that he will actively push for the legislation. "I think there's going to be immense pressure on members of both the House and Senate to support this bill," Bush said as he returned to the White House from a weekend at Camp David. The deal, which was hammered out behind closed doors and largely excluded Democrats, would start by providing prescription-drug discount cards in April that could provide discounts of 15 percent or more. In 2006, seniors could sign up for prescription-drug coverage after paying a $275 annual deductible and premiums roughly averaging $35 per month. Medicare would cover 75 percent of the cost of medicines, and seniors would pay for 25 percent of the cost, up to $2,200. A coverage gap would begin when drug costs exceeded $2,200, but the program would step back in when a senior's out-of-pocket expenses reached $3,600. After that, 95 percent of all drug costs would be covered. For low-income seniors, the cost of all premiums and deductibles would be waived when earnings did not exceed $12,123 a year. Also, the coverage gap after $2,200 would be eliminated. "We are an eyelash away on a plan that has been discussed and debated for six years," said Senate Majority Leader Bill Frist, R-Tenn., who helped resolve the final disputes, along with House Speaker Dennis Hastert, R-Ill.. But that eyelash may be the most difficult part of the journey. Key lawmakers in the Senate expressed their disquiet as the details came to light. "The last thing we want to do is relive the catastrophic health coverage debate of the 1980s, when we passed legislation with broad support from members and seniors' interest groups, and had to repeal it the next year because it lacked support among the seniors it was designed to benefit," warned Sen. Olympia Snowe, R-Maine. And Sen. Edward M. Kennedy, D-Mass. said he did not think the legislation could pass the Senate. "This bill is a partisan attack on Medicare, a respected program that's a lifeline for our senior citizens," Kennedy said. "It will leave millions of seniors worse off than they are today, with higher premiums and higher drug costs." But participants in the negotiations said this is the best chance Congress will have to provide a prescription-drug benefit through Medicare. Congress budgeted $400 billion in the next 10 years to institute the program, and that money is not likely to be available again as the deficit continues to soar. Republican leaders in the House and Senate are banking that it will be too hard to vote no on a bill that ultimately provides senior citizens with some of the assistance they have been seeking to pay for the high cost of prescription drugs. But Republicans had also sought to use the carrot of a prescription-drug benefit to rein in the traditional health coverage of Medicare, which they argue is financially unsustainable because of the nation's demographic changes. Lawmakers agreed to conduct a demonstration program starting in 2010 with private insurance plans competing with the regular fee-for-service Medicare program for six years. The experiment would be conducted in six metropolitan areas to be named. Long considered the most controversial aspect of the legislation, the competition proposal was scaled back considerably from Bush's first draft. The legislation includes far-reaching provisions to rectify longstanding inequities in rural health care, such as unequal reimbursement rates to doctors and hospitals in rural areas, compared to urban centers. Those provisions are expected to cost at least $25 billion in the next decade. "Iowans and taxpayers in 30 other states pay the same payroll tax to help run Medicare as the rest of the country, but have been penalized for providing cost-effective medicine," said Sen. Charles Grassley, R-Iowa, chairman of the Finance Committee. "This will make a big difference in recruiting physicians and maintaining the strong health-care delivery system we have in rural America." In addition, the agreement includes a "Welcome to Medicare" program that will provide new Medicare recipients with a physical exam, as well as screening for diabetes and cardiovascular disease. To control the cost of drugs, Americans would be allowed to buy their prescription drugs from Canada as long as the secretary of Health and Human Services certifies that it is safe. For the first time, high-income Medicare recipients would be charged higher premiums and co-payments under the plan. Seniors with annual incomes exceeding $80,000 would pay more, under a sliding scale. The legislation still faces a difficult and acrimonious road to enactment. First, the Congressional Budget Office must decide that the cost of the bill is within the $400 billion ceiling. Then it must pass the House and the Senate. Bush set the tone for the week as he began to apply pressure to lawmakers to support the deal. "I urge the members of the House and the Senate to take a look at it, vote it and get it to my desk as soon as possible," Bush said, describing the legislation as "complex." "We're changing a Medicare system that has been stuck in the past for a long period of time," he said. "I know I will be actively pushing the bill." The AARP, the premier seniors organization, is expected to endorse the legislation, though on Sunday officials would only say they were "hopeful" and "encouraged" but still examining the legislative language. The American Medical Association, which represents more than 10,000 doctors, offered its support. The bill would stop planned cuts in payments to physicians in 2004 and 2005, and replace them with increases of 1.5 percent. Jill Zuckman is a reporter for the Chicago Tribune, a Tribune Publishing newspaper. Copyright © 2003, Orlando Sentinel

6 democratic candidates attack medicare measure { November 19 2003 } Aarp members burn cards Aarp spends 7m ad campaign supporting gop bill { November 19 2003 } Candidates take on aarp over drug bill Congressman bribed to pass medicare { November 27 2003 } Democrats threaten sue over medicare cost estimates Drug makers protect their turf { November 21 2003 } Drug plan faces enrollment challenge Drug prices for elderly climb 50 percent { July 1 2004 } FDA and states at odds over drugs { February 22 2004 } House probe medciare bribery allegation Medicare administrator withheld cost estimates for congress { September 8 2004 } Medicare costs kept secret Medicare drug benefit will cost more than reported { February 9 2005 } Medicare drug bill could be tough sell { November 17 2003 } Medicare drug cards produce confusion { July 29 2004 } Medicare drug cost estimate increases { January 30 2004 } Medicare reform bill is a disaser { November 28 2003 } Medicare secrecy inquiry is silenced { April 2 2004 } Medicare wont cover cancer drug costs { September 8 2004 } Medicares hidden bonanza { March 4 2004 } New drug benefits too complicated for seniors Nine dems back medicare bill Offered money to change vote { December 8 2003 } Some experts foresee revolt by elderly { November 26 2003 } Top democrats want us house probe on medicare vote US offers senior drug cards amid criticism { May 3 2004 } Files Listed: 27

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