'You're going to have it for awhile': former CMS chief defends the Medicare Modernization Act.(Practice Trends)

CHICAGO -- The Medicare Modernization Act is here to stay, former Medicare chief Tom Scully said at a conference sponsored by America's Health Insurance Plans.

Even if Sen. John F. Kerry (D-Mass.) is elected president and the Democrats take control of the Senate, Republican control of the House would remain a major roadblock to enacting changes to the law, said Mr. Scully, the former administrator of the Centers for Medicare and Medicaid Services.

"I don't see any way in the world that this bill gets reopened," he said. "You're going to have it for awhile."

The Medicare Modernization Act was signed in late 2003 and includes two main components: creation of a prescription drug benefit and a restructuring of Medicare's health care coverage that allows beneficiaries to choose PPO plans, as well as HMOs and traditional fee-for-service coverage.

These two issues drove the bill, Mr. Scully said. "When you get to 65 years old you don't lose your desire to have flexibility in insurance," he said.

If Medicare beneficiaries have the choice, Mr. Scully predicts that they will overwhelmingly choose PPOs under Medicare, mirroring behavior in the under 65 insurance market. By 2008, 35%-37% of Medicare beneficiaries will be in Medicare ...