Attempt to Save Catastrophic Care Falters as GOP Refuses to Support Bentsen Plan

Senate Finance Committee efforts to save Medicare’s controversial catastrophic care program broke down in disarray Tuesday, as Republicans refused to support a rescue plan proposed by Lloyd Bentsen (D-Tex), the panel’s chairman.

Bentsen has refused to push his program through the Democratic-controlled committee without strong support from both Senate Republicans and the White House. Without bipartisan backing, Bentsen said, it will be impossible to prevent total repeal of the catastrophic program, passed overwhelmingly by Congress just a year ago.

“We can’t win (stop repeal) on the Senate floor unless we have bipartisan support,” Bentsen told reporters after abruptly canceling a scheduled Finance Committee meeting without taking any action on his rescue plan.

Calls for Compromise

“We have to face up to the fact that compromises have to be made to get a majority,” he said. “I wish the Administration had some influence with (GOP) members. Although they say they are for the core benefits, they don’t show me they have any votes on their side.”

Bentsen said that the core of the catastrophic care program--financial assistance for beneficiaries with substantial hospital and doctor bills--can be preserved while cutting the surtax on senior citizens that furnishes most of the revenues.

The Democratic committee members generally back Bentsen’s plan to sharply reduce the unpopular surtax, which is to be paid by the 40% of Medicare beneficiaries who pay federal income taxes.

Under Bentsen’s proposal, the surtax rate would drop to 10% from 15% of a beneficiary’s federal income tax liability and the maximum surtax would fall to $400 from $800.

Coverage of prescription drugs, which is scheduled to apply to all medications in 1991, would instead be restricted to drugs used intravenously and compounds used after transplant operations. And the coverage for skilled nursing care would be returned to its previous level by again requiring that the beneficiary must have spent the three previous days in a hospital. Before the three-day requirement was eliminated on Jan. 1, relatively few people qualified for the benefit.

The surtax has generated a storm of opposition from senior citizens, who have converted congressional enthusiasm for the program into a stampede for its revision or repeal.

Bentsen and his allies on the committee still strongly advocate catastrophic care, and they are trying to devise the best strategy to withstand repeal efforts.

“The Democratic members are quite supportive,” he said. “As far as making it bipartisan, I don’t see that.”

The Bush Administration has said officially that it prefers not to make any changes in the program but would support action by the committee. This hands-off position is unacceptable to Bentsen, who wants Republicans to share the political risks of attempting to preserve the catastrophic care legislation.

If Bentsen is to succeed in his efforts to prevent repeal of the bill, Sen. Dave Durenberger (R-Minn.) noted, he needs “to have Democrats and Republicans and the President in the boat with him.”

Durenberger, who is pushing a rival plan with a maximum surtax of about $250, was more optimistic than Bentsen about reaching a bipartisan compromise.

“We’re getting closer,” he said. “It’s like trying to get down from a 10-story building. We’ve reached the fourth story and we’re working our way down.”

Republicans on the committee are split, with some, like Durenberger, pushing a scaled-down program, some advocating total repeal and others seeking to keep full prescription drug coverage under catastrophic care.

Bentsen, although clearly disappointed, said that he would meet again privately with committee members in an effort to reach agreement on a bipartisan package. Meanwhile, the House is moving toward a vote on whether to repeal the catastrophic care program entirely. A repeal amendment will be included in the debate over the financing of federal government programs for the 1990 fiscal year, which begins Sunday.

The catastrophic care program is the biggest expansion of health benefits for the elderly since Medicare was enacted in 1965. It provides unlimited days of government-paid hospital care after the patient pays $560 for the first day in the hospital.