Casting Complete for Medicare Conference

Washington

The House and Senate last month set the stage for a conference that will decide the fate of Medicare reform. Casting Bill Thomas — chairman of the House Ways and Means Committee and an avid supporter of competitive bidding for durable medical equipment — as the overall conference chairman, lawmakers chose eight House members and nine senators to battle over the provisions of dueling prescription-drug packages.

On the Senate side, Republicans Chuck Grassley of Iowa, Bill Frist of Tennessee, Orrin Hatch of Utah, Don Nickles of Oklahoma and John Kyl of Arizona; and Democrats Max Baucus of Montana, John Rockefeller of West Virginia, Tom Daschle of South Dakota and John Breaux of Louisiana will push for a bipartisan bill that calls for a seven-year CPI freeze for DME, as an alternative to competitive bidding. The Senate bill also proposes reducing the reimbursement rate for Part B drugs from 95 percent to 85 percent of the “average wholesale price.”

On the House side, Republicans chose Bill Thomas of California, Billy Tauzin of Louisiana, Nancy Johnson of Connecticut, Mike Bilirakis of Florida and Tom DeLay of Texas will champion a bill that includes competitive bidding, a home health copayment and a reduction to the home health market basket. Democrats Charles Rangel of New York, John Dingell of Michigan and Marion Berry of Arkansas will join the House contingent.

Conference Could Drag On Indefinitely

President Bush is hoping that the conference will be a one-act play — that the conferees quickly will resolve the bills' differences in time to deliver a final version to his desk by early September. However, the conference is shaping up to be an epic drama, as consumer groups, managed care organizations and the lawmakers themselves are finding fault with certain provisions of the bills.

Both bills “are inadequate in that they contain major gaps in coverage and may lead to a loss of coverage for those who already have health coverage from a former employer,” the AARP said.

In a July 8 letter to President Bush, Senate Democrats said they would not accept a compromise that coerces beneficiaries into leaving conventional Medicare to enroll in HMOs and private plans. The letter also demanded that any compromise bill include backup plans for beneficiaries living in areas where private plans are unwilling to provide a drug benefit, and provisions, such as low premiums and copayments, that ensure the drug benefit does not exclude the poorest seniors.