White House, Gop Near Medicare Pact Plan To Save $115 Billion In Five Years Could Protect The Health Plan For 10 Years

After years of bitter fighting over Medicare, the Clinton administration and the Republican Congress moved Tuesday toward a compromise that would extend the financial solvency of the health program for 10 years and offer new preventive care benefits.

The president and congressional leaders met at the White House and both sides talked in tones of conciliation, rather than political conflict.

“There really was a sense in the room that we can get this done and that we can work together despite the disagreements that do exist on some issues,” said White House spokesman Barry Toiv.

Rep. Bill Thomas, R-Calif., prime author of the GOP Medicare bill, also voiced strong optimism, telling a news conference that “there are no areas that cannot be resolved in discussions with the White House and our Democratic colleagues.”

A key element of the recent balanced-budget agreement was a general commitment by the president and congressional leaders to achieve $115 billion in Medicare savings in five years. Exactly how those savings would be realized must be worked out in legislation approved by both houses of Congress. That process begins today in the House Ways and Means Committee, amid expectations for rapid bipartisan agreement.

The detailed GOP plan, offered by Thomas on Tuesday, would assure financial solvency for Medicare’s hospital trust fund until the year 2007. Under current rates of spending, the fund was headed for bankruptcy in 2001.

“I don’t believe there are any deal-breakers left out there,” said Thomas, after disclosing that his plan would limit medical savings accounts known as MSAs to a five-year experiment limited to 500,000 beneficiaries.

The White House is accepting some favorite Republican ideas for expanding health care choices for Medicare patients - those over 65 and the disabled of all ages. The GOP plan would allow doctors and hospitals to create their own health maintenance organizations, bypassing the current HMO industry and insurance companies. It also would allow the new organizations under some circumstances to bypass state licensing and get certification from the federal government.

The financial pain of the plan falls on service providers, doctors, hospitals and HMOS, all facing slowdowns in the rate of growth in their payments from the government to care for Medicare beneficiaries. Lobbying on this issue will be fierce.

Beneficiaries also may be required to pay more. The bill would add another $6.80 a month beyond projected increases in Medicare premiums, which help pay for doctor bills. The premiums, now $43.80 monthly, would be an estimated $68.30 in 2002.

But beneficiaries also will enjoy a new package of preventive services.

Medicare will provide free annual mammography screenings for all women. For women deemed high cancer risks - those with a family history of the disease - there will be free annual pap smears and pelvic examinations. Women without high risk can get the free exams every third year. For men, Medicare will cover annual screenings for prostate cancer.

Colorectal cancer screenings will be covered by Medicare for the first time. Medicare will pay for blood testing strips for diabetics, and for courses on diet and other lifestyle changes.