|
COPYRIGHT 2003 Thomson Financial Inc.
Ideologies drive some aspects of the debate over reconciling House and Senate Medicare prescription-drug measures, such as how, and if, market competition will occur between private health plans and government-run Medicare. But other big issues are a matter of dollars, and the differing tradeoffs the chambers made to hold their bills close to a $400 billion, ten-year cost.
How provisions "score" as enhancers or depleters of federal revenue, according to the Congressional Budget Office, will tell much of the tale. Provisions with big price tags often are most vulnerable to deletion. And how the bills' dollar allotments "score" with provider and beneficiary groups will influence not just the conference outcome but Medicare's future, and perhaps some political futures, for a long time to come.
Among many dollar dilemmas are these:
* The $10 billion gap ... or ... Will federal bureaucrats get enough funding to administer a new and improved Medicare? Both bills would create a new Health and Human Services agency to manage all private-insurer activity in Medicare, as well as competition between private plans and the government-run program. CBO says the cost of setting up and operating the competition center would be $10 billion under either bill.
But there's a difference in the way the two chambers allotted funds, and it allows House Republicans to characterize their bill as significantly less expensive than the Senate's effort.
The Senate made administrative funding for the center a mandatory spending item. That means it's counted in CBO's estimate of the measure's impact on so-called direct federal spending. According to CBO, the Senate legislation would cost $422 billion over ten years
CBO says the House bill...
Read the full article for free courtesy of your local library.
|
Bookmark this article
Print this article
Link to this article
Email this article
Digg It!
Add to del.icio.us
RSS
