CHICAGO – President Bush (search) put his weight behind growing momentum in Congress to pass a Medicare prescription drug plan Wednesday, and the top Senate Democrat said such a plan now seems likely to win approval.
As House Republican leaders labored over the details of their own version of the legislation, GOP aides said it included a provision to save roughly $18 billion over the next five years by holding down increases that hospitals receive to offset the effects of inflation.
The legislation also calls for Medicare (search) recipients to pay higher costs for doctor and out-of-hospital expenses by raising the annual deductible, now set at $100, these aides said, speaking on condition of anonymity.
Bush challenged lawmakers to send him a bill by the Fourth of July.
"We've got a growing consensus in both houses of Congress, and in both political parties, a consensus that our seniors need more choices and better benefits including prescription drugs," he told the Illinois State Medical Society.
"The time is right for progress," he said. "I'm here to urge Congress not to miss the opportunity."
Both the House and Senate bills would offer prescription drug coverage to Medicare beneficiaries, as well as a new managed care option.
As Bush promoted Medicare overhaul on the road, support appeared to be building in Congress.
"I think it will pass," Senate Minority Leader Tom Daschle (search), D-S.D., said.
But Democrats remained divided on GOP-backed plans moving through both chambers, with many suggesting they still don't go far enough to meet the needs of the elderly.
And Daschle and other Democrats said they would seek several changes to strengthen the bill, including one that would close a gap in coverage for Medicare recipients who spend more than $3,450 and less than $5,300 in any one year on prescription drugs.
One Democratic proposal may recommend terminating the prescription drug program after five years, according to Sen. Jon Corzine, D-N.J. That would reduce the overall cost under congressional accounting rules, and the savings could be used to close the gap for all beneficiaries.
Another would provide a government-guaranteed benefit to all Medicare recipients, while a third is designed not to give employers an incentive to cut off private coverage.
At the same time, representatives of the nation's governors wrote key lawmakers during the day, seeking a change in the provision of the legislation that leaves states responsible for the costs of prescription drug benefits for poor elderly who qualify for Medicaid as well as Medicare. "The nation's governors oppose this approach. It is not good health policy and it is not good precedent," wrote Govs. Paul Patton, D-Ky., and Dirk Kempthorne, R-Idaho.
Daschle's remarks underscored the powerful momentum that has developed behind prescription drug legislation in recent days.
The surge began after Bush and his congressional allies, bowing to political realities, agreed to extend benefits to more low-income elderly Americans.
Bush wants to provide prescription drug coverage while offering a new managed care option for seniors. The administration says creation of the new option is needed to modernize the government program and help fix its finances for the longer term.
"Medicine is changing, Medicare is not," Bush said.
The Senate Finance Committee is scheduled to vote on the measure on Friday, and sponsors have expressed confidence they have the support to prevail. That would set the stage for full Senate debate during the last two weeks of the month.
The House is working on a bill of its own and is ready to move quickly on it. Republican sources described the emerging plan as similar to the Senate bill, although higher-income seniors with big prescription costs would pay more of their own expenses than the less well off.
The administration abandoned an earlier proposal that would have offered better prescription-drug coverage for seniors willing to join private health plans. The current version before the Senate would offer equal benefits for people in either the traditional Medicare program or in private plans.
Still, Bush told his audience, "We've got to make sure that no policy of the federal government will undermine the system of private care in America."
Bush also put in a plug for his proposal to limit the size of medical lawsuits, saying huge awards have been driving up the costs of both private and governmental medical insurance.
"No one has ever been healed by a frivolous lawsuit," he said to loud applause from his audience of doctors and other health professionals.
Bush wants to limit non-economic damage awards in medical lawsuits to $250,000.