The race to take action--or at least to appear to do so--on a Medicare prescription-drug benefit began again in Congress today as House Republicans and a pair of Senate Democrats unveiled separate multibillion-dollar proposals.
House Republicans, led by Speaker Dennis Hastert (R-Ill.) and Rep. William Thomas (R-Calif.), shared only the broad outline of a proposed 10-year, $350 billion Medicare drug package. However, details of their plans were described in a draft of the prescription-drug bill obtained by Modern Healthcare's Daily Dose. Those details include proposed changes to Medicare provider payments that likely mean more money for rural hospitals and less for others.
The Republicans are proposing a voluntary drug benefit with a $250 annual deductible and up to 30% cost-sharing for beneficiaries, Thomas told reporters after a media event today. The plan would have a coverage limit, possibly set at $2,000. However, the government would fully cover drugs after beneficiaries reach a maximum out-of-pocket threshold, possibly $4,000.
Republicans showed up in mass today; Hastert's "prescription-drug action team" has more than 35 Republican lawmakers all touting the new bill.
Only two Senate Democrats, Bob Graham (D-Fla.) and Zell Miller (D-Ga.), so far are standing behind a bill that offers a $300 annual deductible, 50% cost-sharing, no coverage limits and an out-of-pocket threshold of $4,000. The Democrats' bill would cost an estimated $425 billion over eight years.
Both sides called for quick action. "Before this month is out, the House of Representatives will have acted; we've talked too long," Thomas said.
Said Miller: "I'm interested in passing a prescription-drug benefit. And I mean passing it before the (November) election."
The Republican bill would extend Medicare's scheduled 2003 payment update for hospitals----.55 percentage points below the industry marketbasket, a measure of inflation--through 2007. The Daily Dose reported Monday that such an extension was being considered in a story on the government's analysis of the hospital market.
"All indications are that hospitals are doing fairly well, some hospitals are doing quite well," Thomas said.
Sole community provider hospitals, however, would receive a full marketbasket update through the next five years, under terms of the draft bill. In addition, the bill would require the marketbasket to be recalculated "more than once every five years" with the best available data.
Speaking to reporters after the media event, Thomas said one goal of the GOP proposal was to "try to design a provider payment structure which takes into consideration the differences of hospitals both in terms of size and location."
Rep. Pete Stark (D-Calif.) reacted with cynicism to the Republican proposal, saying, "Today's announcement was more about making campaign buttons than filling prescription bottles."
--With Susanna Duff