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GOP Gains Feinstein Support on Medicare

Senate Republicans are certain they can pass a prescription drug benefit. Democrats, led by Kennedy, promise to fight the overhaul bill.

November 24, 2003|Richard Simon | Times Staff Writer

WASHINGTON — Senate Republican leaders, confident that they will pass a Medicare prescription drug benefit, headed into a likely showdown vote today by picking up the support of a key Democrat, Sen. Dianne Feinstein of California.

"We're going to deliver a bill," Senate Majority Leader Bill Frist (R-Tenn.) predicted on CNN's "Late Edition" on Sunday.

In a rare Sunday session of the Senate, Feinstein broke ranks with her party's leaders and endorsed what would be the most sweeping change to the health-care program for senior citizens and disabled Americans since it was established in 1965.

"It is not a perfect bill, but it is a first step," Feinstein said.

Still, the bill's opponents promised to try to defeat the nearly $400-billion measure.

Three Democratic senators seeking their party's presidential nomination -- John F. Kerry of Massachusetts, Joe Lieberman of Connecticut and John Edwards of North Carolina -- planned to interrupt their campaigns to return to Washington and join Sen. Edward M. Kennedy of Massachusetts in an effort to block the bill's passage.

The bill, backed by President Bush, is expected to be a key issue in next year's congressional and presidential campaigns.

The bill passed the House, 220-215, at 5:53 a.m. Saturday after GOP leaders held open the roll call for nearly three hours, instead of the customary 15 minutes, while they rounded up the necessary votes.

"This was Florida all over again," Kennedy said on ABC's "This Week" on Sunday, comparing the House Medicare action to the disputed 2000 presidential vote.

At the center of the legislation is an optional prescription drug benefit for most seniors that would begin in 2006. For the first $2,250 in drug costs each year, Medicare would pay 75% after a $250 deductible. Then there would be a gap in coverage, with patients solely responsible for the next $2,850 in drug costs.

Once seniors had paid $3,600 out of their own pockets, Medicare would cover 95% of the cost of subsequent prescriptions. The monthly premiums, starting at about $35, and annual deductibles would increase with inflation.

In addition, the bill would set aside more than $14 billion in payments and risk-sharing for health maintenance organizations and preferred-provider organizations.

The funds are intended to encourage managed-care plans to participate in Medicare and to help them offer better benefits packages at lower costs than the traditional fee-for-service program Medicare offers. Starting in 2010, pilot programs in six areas would allow managed-care plans to compete with the current program.

Senate Minority Leader Tom Daschle (D-S.D.) told NBC's "Meet the Press" on Sunday that opponents would work as hard as they possibly could to defeat the measure. He did not explain the procedural actions they might try.

Frist expressed confidence that the bill's supporters would prevail.

"They can't stop it," he said on CNN. "There's no way. The American people, the seniors, deserve it, and we're going to deliver it."

While Frist criticized Democrats for fighting the Medicare bill, a fellow Republican, Sen. John McCain (R-Ariz.), said he would join Kennedy in opposing the bill.

"My viewpoint is, here we are, a nation with a half-a-trillion-dollar deficit coming up, multitrillion-dollar deficits, growth of government, 12.5% last year," McCain said on ABC's "This Week." "What's ever happened to my party's fiscal discipline?"

During Sunday's debate, Feinstein said the bill would bring "substantial help" to the people she represents.

It would, she said, make prescription coverage available to more than 4 million Californians, including 351,000 low-income Medicare beneficiaries in California who are not eligible for Medi-Cal and have no prescription drug coverage.

It would also provide $1 billion nationally to states for emergency medical care to undocumented immigrants over four years, including about $288 million to California, and restore $600 million to California hospitals for treatment of low-income patients over 10 years.

Joining Feinstein, Sen. Ron Wyden (D-Ore.) said he would vote yes if the bill represents the "sole opportunity to inject $400 billion in a long-sought prescription drug benefit into Medicare."

"I will not vote to let the last train that leaves the U.S. Senate go out without $400 billion to be used to help vulnerable seniors and those who are getting crushed by prescription drug costs," he said.

California's other senator, Democrat Barbara Boxer, opposes the measure, contending that it does "great damage" to Medicare and is a "gift" to the pharmaceutical industry and HMOs because, among other things, it forbids Medicare to bargain for lower prices, her spokesman said Sunday.

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