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The specifics of the 1,100-page bill are still dribbling out, but already the largest senior citizen organization in the state is endorsing it.
Iowans begin sorting through proposed Medicare drug bill
By Ed Tibbetts
A day after Republicans in Congress announced they had struck a deal to add a prescription drug benefit to Medicare, longtime Davenport physician Dr. Jack Sunderbruch tried to sum up the expectation senior citizens have for the plan.
“I think most people are willing to pay something,” he said Monday at the Center for Active Seniors Inc. “But they don’t want their drug bill to rob them of their daily meal.”
In Iowa, as in the rest of the country, senior citizens, hospitals, doctors and politicians began Monday to chew over the details of what would be the largest expansion in history of the program that delivers health care to 40 million Americans nationwide and nearly half a million people in Iowa.
Republicans revealed details of an agreement Sunday, saying they hope to vote on a final package by Thanksgiving.
The specifics of the 1,100-page bill are still dribbling out, but already the largest senior citizen organization in the state is endorsing it. And hospitals that have been lobbying for changes in how they are reimbursed for Medicare services were smiling on the estimated $300 million the deal will pump into Iowa as a result of changes to how they, doctors and home health-care agencies and ambulance services are paid for the services they provide.
For years, they have claimed Medicare cheats them because of a formula that devalues rural providers.
The drug coverage that is the centerpiece of the plan would cost seniors $35 per month in premiums and carry a $275 deductible. It would pay for 75 percent of drug costs up to $2,200 and then pay nothing until costs reached $3,600. After that, the government would pick up the rest.
For a typical senior with drug costs of $3,160 in 2006, when the benefit kicks in, the out-of-pocket costs would be $2,100, according to an estimate from the Kaiser Family Foundation, which studies Medicare issues. However, Tricia Neuman, an official with the foundation, warned that every situation is different.
Indeed, U.S. Sen. Tom Harkin, D-Iowa, complained that someone with a $4,000 drug bill would pay $3,000 in out-of-pocket expenses. He said the bill would provide little relief for seniors, even while delivering billions to private insurance and drug companies.
“It’s just not a good deal,” he said. “They used it as a Trojan horse to make changes in Medicare.”
Asked if he might support a filibuster in the Senate, Harkin said he wants to see more details first. But the senator made it clear he does not like the GOP plan.
Across the aisle, U.S. Sen. Charles Grassley, R-Iowa, took a different view. “If Congress doesn’t act now, seniors won’t gain access to affordable prescription drugs through Medicare in the foreseeable future,” Grassley, a key architect of the plan, said.
A representative of the Iowa AARP said Monday that now is the time to act. “We all recognize it’s not a perfect bill, but we also recognize we can’t wait for perfect,” said Bruce Koeppl, the state director for the organization, which endorsed the deal. “There needs to be some progress and this is a good step forward.”
Meanwhile, representatives of Iowa hospitals said the proposal would help close the $100 million annual gap between Medicare services provided in the state and the amount the government pays providers for those services.
The agreement would pay Iowa health-care providers more than $300 million over 10 years. Also, providers serving a disproportionate share of uninsured and Medicaid recipients also would get $141 million over 10 years.
Hospitals in rural areas are especially susceptible to Medicare reimbursements because a majority of their patients are under the auspices of Medicare. In the Quad-Cities, the impact is less severe, but even Trinity Regional Health System gets about 10 percent of its revenue from Medicare. Officials there have been eagerly watching the outcome of the process.
The Iowa Hospital Association was studying the details Monday, but Scott McIntyre, a spokesman for the organization, said, “The major provisions regarding equity are there.”
The deal provides hospitals with a full inflation adjustment next year and continues it for three years after that as long as quality goals are met. It also changes how much wages are used to figure Medicare payments to providers.
U.S. Rep. Jim Nussle, R-Iowa, said he is “very encouraged.” A spokesman for U.S. Rep. Lane Evans, D-Ill., could not be reached for comment Monday by the QUAD-CITY TIMES.
Ed Tibbetts can be contacted at (563) 383-2327 or etibbetts@qctimes.com.
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