Conferees Agree to Catastrophic Care’s Repeal

Senate conferees agreed early today to accept total repeal of the controversial catastrophic care program under Medicare.

However, dissident senators vowed to wage a filibuster to save the expanded hospital care program for 33 million Medicare beneficiaries. The fate of catastrophic care thus remains cloudy as Congress struggles under the pressure of a drive to adjourn for the year.

The only certain result is that Congress will eliminate the controversial surtax that sparked a rebellion among senior citizens against the program. The tax would have been paid by the 40% of persons over 65 who pay federal income taxes. It would have ranged up to $800 a year for an individual and $1,600 for a married couple.

The House previously had voted for total repeal and insisted on this position repeatedly during rancorous negotiations with the Senate, which had voted to preserve hospital care, an expansion of skilled nursing coverage and some other benefits.

Just after midnight, the Senate negotiators caved in, agreeing to accept total repeal.

“There was a lot of deep disappointment, starting with me,” said Sen. Lloyd Bentsen (D-Tex.), leader of the Senate conferees.

But a rebellion immediately erupted. Sen. John McCain (R-Ariz.) angrily threatened a filibuster against the proposed repeal, declaring: “I will have to use every legitimate parliamentary tactic I can think of to see that this incredible injustice is not perpetrated on seniors across this country.”

Senate Minority Leader Bob Dole (R-Kan.) backed up McCain. “I can assure you I will do all that I can. We should not capitulate to the House,” he said.

An angry McCain said that the Senate should not retreat from its overwhelming 99-0 vote last month to preserve part of the catastrophic care benefits.

“I am fully aware of the pressure for leaving as of Monday evening,” he said.

But in the courtly language used by senators when they promise to tie up the Senate by speaking for an indefinite time, McCain said: “I intend to exercise my rights as a senator. We can’t do this to seniors in America, we can’t do this. It will be a terrible thing to have people forced to leave skilled nursing centers.”

Congress has ridden a political and emotional roller coaster over catastrophic care. It was passed overwhelmingly in 1988, and acclaimed as the biggest expansion of federal health benefit programs since the creation of Medicare in 1965. But its financing--a unique tax on the beneficiaries of Medicare--sparked a rebellion among senior citizens throughout the country. Congress then rushed to dismantle a program that it had created with great fanfare.

The original catastrophic care program provided unlimited days of hospital care after the patient paid for the first day, a cap on out-of-pocket spending for doctor bills, Medicare coverage of prescription drugs for the first time, and expanded skilled nursing benefits. The House voted for complete repeal of the entire package. The Senate decided to keep the unlimited days of hospital care, and other benefits.