Medicare Reform Legislation: An Update

After years of discussion and debate, both Houses of Congress passed bills providing for Medicare prescription drug coverage in July, 2003. In September 2003, conferees from both the House and Senate resumed their attempt to iron out the differences between the two bills and enact the most extensive expansion of the Medicare program since its inception.

What were the major ways in which the House and Senate bills differed from each other and from current law? What were the major points of contention? What was likely to emerge from the negotiations? If the measure were passed, how would the health care world respond? How would employers respond? How would beneficiaries and the delivery system be affected?

To help address these and related questions, the Alliance for Health Reform and The Commonwealth Fund cosponsored an August 15, 2003 briefing. Panelists were some of the country’s leading experts on Medicare: Julie James of Health Policy Alternatives; Marilyn Moon of the American Institutes for Research, a former trustee of the Medicare program; Dale Yamamoto, chief actuary for the health care practice at Hewitt and Associates, who had studied the likelihood of employers dropping retiree drug coverage if a Medicare drug bill passes; Brian Biles, a professor at George Washington’s School of Public Health and Health Services, who addressed the possible effect of the managed care provisions in House and Senate bills; and Joseph Antos of the American Enterprise Institute, who concentrated on the provisions in the House bill to have traditional Medicare compete against private plans beginning in 2010. Ed Howard of the Alliance moderated the discussion.