Against the backdrop of the White House Conference on Aging-which brought more than 2,200 senior citizens to Washington-Democrats and Republicans spent last week sparring over the future of the Medicare program.
For much of the week, Democrats had Republicans on the defensive, arguing that the GOP intends to pay for the nearly $200 billion in tax cuts passed by the House earlier this year with Medicare spending reductions.
President Clinton told the Conference on Aging that it was impossible to "solve the deficit problem....until we are able to moderate the growth of healthcare spending.
"I believe it is wrong to slash Medicare and Medicaid simply to pay for tax cuts for the well-off," Clinton added.
Republicans countered that the cuts were necessary to preserve the Medicare Hospital Insurance Trust Fund, which pays for Medicare Part A, and that they would be subsidized by restructuring the Medicare system.
"It is essential that we begin a conversation with the American people about the condition of their Medicare and the dire necessity to work to solve it," said House Ways and Means Committee Chairman Bill Archer (R-Texas).
Senate Majority Leader Bob Dole (R-Kan.) and Speaker of the House Newt Gingrich (R-Ga.) called on the White House to release its own plan to reform Medicare and to meet on a bipartisan basis to discuss the plan.
However, Clinton administration officials said they would only meet after the Republicans released their budget and agreed to discuss Medicare changes in the context of broader healthcare reform.
But while the politics of Medicare reform took center stage in public, behind closed doors, Republicans in the House and Senate worked to put the finishing touches on their federal budget proposals.
House Republicans took a three-day retreat to suburban Virginia during which they hashed out the details of their plan, including how Medicare spending would be reduced.
Sources who asked not to be identified said last week that when the House budget is unveiled, the cuts would be "in the $250 billion range" over seven years.
Medicare spending is projected by the Congressional Budget Office to grow to $286 billion in 2000 from $176 billion in 1995, an average of about 10% a year. According to Republican data, Medicare would still grow by an average of more than 7% per year even if reduction of $250 billion were enacted over seven years.
Provider groups came to Capitol Hill armed with an American Hospital Association poll showing that more than two-thirds of voters say Congress will break its pledge not to cut Social Security if it reduces Medicare spending. They pushed Republican leaders to lower the level of reductions.
The groups favor a plan introduced earlier this year by Sen. Judd Gregg (R-N.H.) that would reduce projected Medicare spending by $100 billion over five years but would garner nearly 40% of those savings by moving more seniors into private managed-care plans.
"We're not saying `don't touch Medicare at all,'*" said Richard Pollack, AHA executive vice president for federal relations. "What we're saying is that the level of cuts they are talking about now are not acceptable. If they really want to look at Medicare they have to look at all aspects of it-the structure of the system, the revenue stream and benefits."