Senate
revises Medicare
WASHINGTON (AP) — The Senate gave
final congressional approval Tuesday to
the most sweeping changes to Medicare since
its creation in 1965, including a new prescription
drug benefit for 40 million older and disabled
Americans. The 54-44 vote sends the bill
to President Bush, who is eager to sign
it into law.
Supporters
said the $395 billion measure, which gives
private insurers a large new role in health
care for seniors, was a long overdue change
for the 38-year-old Medicare program.
Drug
coverage won’t begin until 2006, although
seniors next year will be able to purchase
a drug discount card that officials said
could reduce their pharmacy bills by 15
to 25 percent.
Seniors
‘‘will finally have the prescription
drug coverage they need and the choices
they deserve,’’ Senate Majority
Bill Frist of Tennessee said. ‘‘At
the same time, it preserves traditional
Medicare.’’
The
tally fell largely along party lines. Forty-two
Republicans, 11 Democrats and an independent
backed the legislation. Nine conservative
Republicans joined 35 Democrats in opposition.
The
GOP-controlled House passed the bill near
dawn on Saturday on a 220-215 vote, also
split by party affiliation.
Bush
sees signing the bill as fulfilling both
his and many lawmakers’ campaign promises.
At
its heart, the Medicare legislation was
designed as a grand bargain, with the new
drug coverage for all Medicare beneficiaries
long sought by Democrats combined with a
Republican-backed plan to give private insurance
companies a vast new role in health care
for the program’s beneficiaries.
Under
the legislation, seniors would be eligible
beginning next year to purchase a Medicare-backed
discount drug card at a cost estimated at
$30 a year. The administration estimated
the card would mean savings of between 15
percent and 25 percent off retail prices;
critics argued those numbers were wildly
inflated.
Beginning
in 2006, the legislation would allow seniors
to purchase coverage for their prescription
drugs. GOP officials estimated the drug
insurance premium would be $35 a month,
with a $250 deductible. The coverage would
pay 75 percent of costs after that until
a recipient’s drug costs reached $2,250.
After that, there would be no drug coverage
until a recipient’s out-of-pocket
expenses reached $3,600, or roughly $5,100
in overall prescription expenses. Above
that level, insurance would pick up roughly
95 percent of costs.
The
measure included subsidies for low-income
seniors.
The
scope of the bill went far beyond prescription
drugs, though, including an additional $25
billion for rural hospitals and health care
providers, a requirement for higher-income
seniors to pay more for Medicare Part B
coverage and billions of dollars to discourage
corporations from eliminating existing coverage
for their retirees once the new government
program began.
The
bill would satisfy other goals of conservatives,
including creation of tax-preferred health
savings accounts, open to individuals who
purchase high-deductible health insurance
policies.
Most
contentious of all, the legislation would
create a limited program of direct competition
between traditional Medicare and private
plans, beginning in 2010.
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