Compromise Eludes Joint Panel on Medicare

House and Senate Medicare conferees got off to a slow start Tuesday, citing the “historic” nature of their negotiations but conceding that they are unlikely to produce a compromise bill before September.

The conference committee agreed only to meet again next week to decide how to go about trying to reconcile significant differences between the House and Senate over how to add a prescription drug benefit to Medicare and how much to privatize the 38-year-old program.

Disagreement among the committee’s 11 Republicans and six Democrats was evident even on the question of how to proceed.

While committee Chairman Rep. Bill Thomas (R-Bakersfield) suggested that conferees divide into groups that would tackle separate areas of the $400-billion Medicare reform bills, Sen. John B. Breaux (D-La.) said later he did not like that idea.

“We can do it together,” he said.

The disparities between the Senate and House bills reflect not only differences in Medicare policy but also the distinct character of each chamber.

In the almost evenly divided Senate, lawmakers reached across the political divide to produce a moderate bill that, while disliked by liberal Democrats and conservative Republicans, garnered 76 of the 97 votes cast.

Several senators urged the conferees to take a similar approach.

“Policy differences are fine ... but lines in the sand are not,” said Sen. Charles E. Grassley (R-Iowa), chairman of the Senate Finance Committee and vice chairman of the conference committee.

“We must pass legislation that has large support on both sides of the aisle in both chambers,” said Sen. Max Baucus (D-Mont.). “If we do, the American public will know it’s for real, not political.”

In the more openly partisan House, however, GOP leaders had struggled to gain a simple one-vote majority for their bill. It does much more than the Senate version to move seniors out of traditional Medicare and into preferred-provider organizations or HMOs.

Rep. John D. Dingell (D-Mich.) said it would be better for the committee to do nothing than to adopt the House bill, which he said “privatizes the entire Medicare program in seven years.”

But Sen. Don Nickles (R-Okla.) called the Senate legislation the “biggest, most expensive expansion” of a government entitlement in U.S. history, and said he would vote for a compromise only if it succeeded in making Medicare “affordable and sustainable for future generations.”

Both the House and Senate versions of the bill would partially cover Medicare beneficiaries’ drug costs. After seniors paid monthly premiums of about $35 and annual deductibles of $250 or $275, Medicare would pick up at least half of their drug costs up to a certain amount. Seniors would then have to pay all of their drug costs until catastrophic coverage kicked in after roughly $5,000 in expenses.

Conferees are expected to work through relatively noncontroversial issues before moving on to key differences. These differences include the Senate’s call for a government-provided drug benefit if sufficient private insurers do not offer it, the House’s plan for head-to-head competition between Medicare and private insurance companies, and a $174-billion add-on to the House bill that would expand tax-free medical savings accounts.

President Bush has made Medicare reform one of his top domestic priorities, and he was scheduled to meet late Tuesday afternoon with a bipartisan group of conferees. Instead, the White House abruptly canceled the session, and the president met only with Senate Majority Leader Bill Frist (R-Tenn.) and House Speaker Dennis J. Hastert (R-Ill.).

Spokesmen for the GOP leaders downplayed the change in plans, but Rep. W.J. “Billy” Tauzin (R-La.) had told reporters that Republicans were trying to get the White House to expand its invitation list to include all members of the conference committee.

Tauzin said Republicans were working closely with the White House but that it was up to conference committee members to produce a workable compromise.

“Shame on us,” said Tauzin, if the conferees fail to reform Medicare and give its 40 million senior and disabled beneficiaries help with prescription drug costs.

Both chambers passed their bills June 27, but Thomas said the conference committee could not get down to work until it received from the Congressional Research Service an analysis of the differences between the two bills.

Democratic congressional aides questioned that explanation, noting that interest groups and think tanks had produced numerous side-by-side comparisons of the bills.

Rep. Tom DeLay (R-Texas) said earlier Tuesday that the committee would “take as long as it takes to get it right. It would be nice if we could all get together and sing ‘Kumbaya’ and get a bill by [Congress’] August break, but that’s probably undoable.”

Frist, a physician, said the committee’s responsibility to America’s seniors required members to put aside partisan differences.

He read a letter from a widow named Loretta who said that she spent half of her $1,200 monthly income on prescription drugs.

“I never thought that I would have to go begging for medicines,” she wrote to Frist.

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Times staff writer Janet Hook contributed to this report.