President George W. Bush, saying a consensus was within reach, agreed with key lawmakers on Monday to push for a comprehensive reform of the Medicare old-age health system this year, participants said.
"He said he wanted to try to get it done this year," Rep. Bill Thomas, a California Republican, told reporters after the lawmakers met Bush at the White House.
Lawmakers said Bush wanted to build on a review by a bipartisan Medicare reform commission that completed its work in 1999 but failed to officially adopt its recommendations. They said Bush was willing to include his proposal for stopgap prescription drug coverage, which has met objections in Congress, in the deliberations on broader reform.
Bush told reporters after the meeting, "I believe the framework for a bipartisan consensus about how to make sure the Medicare system fulfills its promise is at hand."
Bush met with four Republicans: Thomas, Sen. Bill Frist of Tennessee, Sen. Charles Grassley of Iowa and Rep. Billy Tauzin of Louisiana. Sen. John Breaux of Louisiana was the only Democrat in the group.
Frist said after the meeting the group agreed to work with Bush to develop a set of principles to follow in crafting Medicare legislation.
Grassley said any comprehensive bill must include a universal, affordable and flexible prescription drug benefit for seniors. The current Medicare program provides no prescription drug coverage.
BREAUX-FRIST BILL A STARTING POINT
Breaux and Frist have proposed legislation the president says could be a starting point for comprehensive Medicare reform.
In his joint address to Congress last Tuesday, Bush made a case for quick action on comprehensive reform.
"Medicare's finances are strained and its coverage is outdated," he said. "The framework for reform has been developed by Sens. Frist and Breaux and Congressman Thomas, and now, it's time to act."
He noted that 99 percent of employer-provided health plans provided prescription drug coverage, while Medicare did not.
He has previously cited estimates the system would go broke by 2025 without major changes, as retiring baby boomers flood into the government program.
The Breaux-Frist legislation would seek to foster private competition to provide Medicare insurance coverage and offer optional prescription drug coverage. It would create a new federal agency to oversee competition between government-run Medicare plans and private Medicare insurers.
Bush has proposed a stopgap "immediate helping hand" program that would immediately provide coverage through states for catastrophically high drug costs and to low-income seniors. It would cost $48 billion over four years.
OPPOSITION TO STOPGAP
But opposition to the plan has arisen from Democrats who said more than two-thirds of seniors would be ineligible under that plan and from Republicans who said many states oppose it.
Bush indicated to reporters on Monday he would be willing to fold in the helping-hand proposal to congressional work on comprehensive reform.
White House spokesman Scott McClellan said the stopgap program may not be necessary if a comprehensive Medicare bill that included drug coverage were quickly enacted. But he said Bush remains ready to push the proposal if broader reform stalls.
Democrats have also criticized as insufficient by half Bush's provision in his 2002 budget request of $153 billion over 10 years for modernizing Medicare reform.
Thomas, chairman of the House Ways and Means Committee, said this issue was discussed at Monday's meeting and that an evaluation of the provision would be made once the Congressional Budget Office made new projections.
In 1999, Breaux and Thomas headed a 17-member bipartisan commission on Medicare reform that came one vote short of reaching the 11-vote supermajority needed to adopt its recommendations, which resembled those in the current, slimmed down legislation the lawmakers have proposed.
The commission proposed providing government premium subsidies for private insurance for Medicare patients, including a prescription drug benefit for poor seniors.
But, amid criticisms by the administration of former President Bill Clinton, all Clinton's appointees united to block adoption on the grounds that it would not provide adequate coverage, including for prescription drugs.