>Votes in the US House of Representatives and US Senate set the stage for upcoming Congressional conference committee talks on a final compromise version of the bill that also creates a broad new role for private insurance in the government-run program, according to an Associated Press report.
>The lopsided Senate vote was a bipartisan 76-21 while the other chamber turned in a squeaker – a 216-215 tally along party lines. The House vote reflected a decision of the GOP leadership to court conservatives eager to inject a strong dose of free-market competition that most Democrats attacked as a step toward privatization. Passage was in doubt until Republican leaders prevailed on Representatives C.L. Otter (R-Idaho) and Jo Ann Emerson (R-Missouri) to switch their votes long after time for the roll call had expired.
>To further shore up conservative support, House GOP leaders pushed through a companion measure in the hours leading up to the Medicare debate. It would allow some individuals to defray the cost of health insurance and prescription drugs with tax-free dollars accumulated in special savings accounts. The bill would cost $174 billion over the next decade, and passed 239-191, along party lines.
>Legislative leaders were almost giddy in their reactions after the Medicare reform votes. “We are one step closer to providing real health care security to seniors all across the nation,” said Senate Majority Leader Bill Frist (R-Tennessee). “Competition, choice, the marketplace, these are the concepts that will save Medicare for the coming decades,” said House Speaker Dennis Hastert (R., Illinois). “Seniors will long remember if you vote for them today, but they will never forget if you vote against them.”
Two Reform Versions Similar
>Both the House and Senate bills were similar in outline. Seniors would receive prescription drug coverage, paying monthly premiums, a deductible and co-payments. Both plans included a gap in coverage, as well as protection for seniors with unusually high annual expenses.
>In addition, the measures created a new managed care option for seniors, part of the administration’s effort to modernize the program while introducing cost-saving measures that could shore up its finances. In an effort to attack rising drug costs, both bills also include measures to speed access to generic medicine, and to allow importation of brand-name pharmaceuticals from Canada, where they are far cheaper than in this country.
>While the bills differed widely in their details, they envisioned the most fundamental changes in Medicare since its creation during the Great Society of nearly four decades ago.
>Beneficiaries would have access to prescription drug coverage, with plans to be offered by private insurance companies and partially subsidized by the government. Lower-income older people would receive greater help from the federal government with the cost of their drugs.
>The drug coverage would begin in 2006. Until then, discount cards would be available that Republican officials said would reduce costs of prescription medicine by 15% or more.
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