TOPICS > Politics

Rx for Medicare: Background

November 24, 2003 at 12:00 AM EDT

KWAME HOLMAN: A key vote on the Medicare prescription drug bill came early this afternoon on an attempt by Senate Republican Leader Bill Frist to end debate once and for all and force senators either to pass the bill or defeat it.

SEN. BILL FRIST: America’s seniors have waited 38 years for this prescription drug benefit to be added to the Medicare program. And today they are just really moments away from the prescription drug coverage that they desperately need and that they deserve.

Yet we have before us an attempt to block the ability, the opportunity for this body to express, through an “up” or “down” vote, their will, to deny seniors and individuals with disabilities access to that affordable prescription drug coverage and thus stand in the way of health care security for those seniors.

KWAME HOLMAN: It was clear from floor statements made this morning and during two rare weekend sessions that a majority of senators, such as Arkansas Democrat Blanche Lincoln, did favor the bill, albeit grudgingly.

SEN. BLANCHE LINCOLN: Is this a bill I would have written? Absolutely not. But there are components in this bill that are productive and move us forward. And on behalf of our seniors, we must, we must seize that opportunity.

KWAME HOLMAN: The estimated price tag of the bill is $400 billion over ten years, largely to subsidize prescription drug coverage for some 40 million seniors and disabled people. The cost of the program alone turned some fiscal conservatives against it. Arizona Republican John McCain:

SEN. JOHN McCAIN: By the year 2020, social security and Medicare, with a prescription drug benefit, will consume an estimated 21 percent of income taxes for every working American. Mr. President, I think we ought to be honest with the American people. Passing this package without implementing the necessary reforms to ensure that Medicare system is solvent over the long- term is rearranging the deck chairs on the “Titanic.”

KWAME HOLMAN: The new government- sponsored drug program will begin in 2006 and will be available to seniors through traditional Medicare and those who choose private health plans. Seniors will get 75 percent payment of annual drug costs up to $2,250.

No payment of drug costs between $2,250 and $5,000, but 95 percent payment of costs above $5,000.

Starting next year, seniors will get a discount drug card for 15 percent or more off their drug bills until the new program begins. Seniors will pay an average premium of $420 and $250 deductible. Louisiana’s John Breaux is one of the Democrats who helped negotiate the details.

SEN. JOHN BREAUX: We can argue which party benefits from a Medicare reform bill and which party would suffer, but the real issue is not whether the Democratic Party or the Republican Party wins or whether the president gets to sign a bill that reforms Medicare in the Rose Garden or the Oval Office.

The real question before this institution on both sides of the aisle, should be whether, for once, we can come together and craft a piece of legislation that creates a program that is substantially better than the 40 million seniors currently have under the Medicare legislation.

KWAME HOLMAN: Senators today were hard-pressed to recreate the drama and passions that surrounded the House action on the Medicare bill during the pre-dawn hours of Saturday. House Republican leaders had to hold open the final vote on the bill for three hours Saturday morning while they scoured the seats and aisles in search of members who could be convinced to switch their votes from “nay” to “yea” and overhaul the package. They finally succeeded at 6:00 A.M.

SPOKESMAN: On this vote the yeas are 220, the nays are 215. The coverage is agreed to.

KWAME HOLMAN: That action by Republican leaders in the House angered many Democrats in the Senate, giving Edward Kennedy of Massachusetts new hope that his colleagues would support a filibuster extending debate on the Medicare bill indefinitely.

SEN. EDWARD KENNEDY: Then after twisting arms, cajoling, effectively bribing members in the House of Representatives, keeping the tab open for three hours, they were able to bring together and carry it by just four or five votes, Mr. President, this overwhelming new program that is so good for everyone and now trying to jam it through the United States Senate we all know what’s going on. It’s the objective of our good friends on the other side, and that is the beginning of the dismantling of the Medicare system. Make no mistake about it.

KWAME HOLMAN: The one element of the new Medicare bill Kennedy and many liberal Democrats most vehemently oppose is the provision beginning in 2010 encouraging private health plans to compete directly with the traditional fee for service Medicare program. But Maine’s Olympia Snowe, a moderate Republican, reminded her colleagues that the program is a six-year demonstration project, much smaller than what many conservatives originally pushed for.

SEN. OLYMPIA SNOWE: So where the efforts once centered on an open, wide national program that would have ultimately ended up in the wholesale undermining and destabilization of the Medicare program, we now have a pared- back demonstration project that would be limited to six metropolitan statistical areas that, in fact, it would not include more than 650,000 to one million seniors.

This demonstration project will not undermine the underlying traditional Medicare program as we know it. Obviously, it would be preferable not to have anything in this legislation, but this is the essence of the compromise that is before us and it is very limited in terms of size and scope, and I think that, Mr. President, it is important for members of the Senate to realize that.

SPOKESMAN: The yeas are 70, the nays are 29. Three-fifths — having voted in the affirmative…

KWAME HOLMAN: Ten more senators than required agreed the debate on Medicare had gone on long enough and called for a final vote. Another procedural attempt to block the bill using the Senate’s budget rules also fell short. Several final hours of debate could take the Senate well into this evening or early tomorrow, but it appears the Senate is poised, as the house did early Saturday morning, to approve the first significant changes in Medicare in the program’s 38- year history.