Medicare Buy-In Proposal May Be off the Table

WASHINGTON — An in-the-works proposal to allow people younger than 65 to buy into Medicare is fading as senators continue healthcare reform negotiations in an effort to reach an agreement that can attract 60 votes.

Sen. Joseph Lieberman (I-Conn.), whose opposition to the Medicare buy-in proposal may have scuttled the deal, said he wasn’t explicitly told by Senate leaders that the Medicare expansion plan was off the table, but “it’s heading in that direction,” he told reporters Monday after a closed-door meeting with Democrats.

Lieberman is a crucial player in the healthcare reform debate because Senate Majority Leader Harry Reid (D-Nev.) needs both of the Senate’s Independents, and all Democrats, to vote for the bill to break an expected Republican filibuster. But Lieberman is opposed to a public insurance option and opposed to expanding Medicare, which was seen as a possible substitute for a new, government-run plan.

“[The buy-in] is constructed in a way that I think would have been more expensive than the subsidies would have been,” said Lieberman, referring to the government subsidies that low-and middle-income people would receive under the healthcare reform bill to help them afford health insurance.

Lieberman didn’t divulge much about the caucus meeting, but other senators were even more tight-lipped.

When Sen. Jay Rockefeller (D-W.Va.) was asked whether there was an agreement to axe the Medicare buy-in plan, he said “I could answer that, but I probably shouldn’t.”

Sen. Ben Nelson (D-Neb.) told reporters that senators didn’t specifically talk about the Medicare buy-in. Nelson’s vote is also seen as a crucial one, especially after his amendment to put new restrictions on abortions failed in the Senate.

Senators are avoiding discussing what exactly is the agreement brokered by five liberal Democrats and five moderate Democrats last week. The agreement was sent to the Congressional Budget Office (CBO) for a cost-estimate, and senators have not yet been given a figure, Nelson said.

Meanwhile, Senate leaders took to the floor on Monday evening to lay out a new plan to close the so-called “doughnut hole” in prescription coverage for the elderly.

Under Medicare’s Part D prescription drug program, patients currently pay the first $295 of their costs. Medicare then covers 75% of the remaining costs until the total reaches $2,700. At that point, patients must foot 100% of their costs until total out-of-pocket spending reaches $4,350.

This void in coverage is called the “doughnut hole.” The current Senate bill would shrink the gap in coverage by raising raising the lower spending level to $3,200.

“Imagine your car insurance covered you until you drove 2,700 miles in a given year, then stopped, then started covering you again once you hit 6,100 miles,” Sen. Reid said on the Senate floor. “That wouldn’t work for drivers, and the ‘doughnut hole’ doesn’t work for seniors.

“The effects of this broken system are painfully simple: more and more seniors have to skip or split the pills they need to stay healthy,” Reid said.

The healthcare reform bill passed by the House eliminates the doughnut hole completely, which is what Reid said he’d like the Senate bill to do as well. But senators won’t vote on the matter during debate: Reid said it would be added to the combined bills when the House is in conference with the Senate.

Sen. Max Baucus (D-Mont.) said he’s “very certain” that a bill will pass the Senate within a few weeks.

source : www.medpagetoday.com

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