Democrats May Drop Medicare Expansion

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Senate Democrats may abandon a proposed expansion of Medicare from health care legislation. Lawmakers say the move is probably necessary to pass the bill.

ROBERT SIEGEL, host:

This is ALL THINGS CONSIDERED from NPR News. I'm Robert Siegel.

MELISSA BLOCK, host:

And I'm Melissa Block.

Senate Democrats are struggling to hold their caucus together and pass a health care bill by Christmas. In order to do that, it looks like the Democrats may have to drop a plan that would expand Medicare. They merge from a closed door meeting tonight on Capitol Hill.

NPR's Audie Cornish was there to hear what they had to say. And Audie, what do they tell you about what happened at the meeting tonight?

AUDIE CORNISH: Well, it appears that Senate Democrats essentially tried to rally around the idea of some sort of health care bill that would not have a public option or any kind of national plan, or their most recent compromise idea expanding Medicare to people under the age of 65. This was a compromise that had been hatched by moderates and liberals as a way to sort of have something that wasn't quite the public option but would still be government-run. And senators came out of the meeting, saying that we can't give you a definite, but it definitely looks like this option, this Medicare expansion option, is out.

BLOCK: Well, tell us more about that option. How would it expand Medicare exactly?

CORNISH: Well, right now, Medicare is available to folks reaching the age of 65 and up. This would have expanded it to 55 and up, and that would've brought in, of course, many more people onto this health care option. And it would've been sort of close to the public option idea in that the rates could be negotiated with the government, so ideally, getting better rates for people who get onto this plan. And also, it would be a policy that essentially, the benefit standards, again, could be set by the government.

So the problem with it is lots of rural senators hated it because they say that their states often get a raw deal when it comes to Medicare reimbursement rates. You had lots of moderate and conservative senators who didn't like it because they just don't want anything resembling a public option in the bill. And it looks like, essentially, those folks want out because many senators who came out of the meeting today said there are not 60 votes, there is not a majority of senators who will support this bill when it comes down to it on the Senate floor.

BLOCK: And besides the Medicare expansion plan, Audie, other obstacles to the Senate health care bill?

CORNISH: Well, this is the biggest obstacle. And to be fair, the Congressional Budget Office is still crunching the numbers on this plan. So we expect those numbers to come out tomorrow.

Another thing that's a real issue is abortion language. In the House bill, there is an amendment that essentially would make it very difficult for people who get any kind of federal subsidies related to the health care reform from using it to cover an abortion. And there are senators who want to do the same thing in the Senate bill. That language simply isn't hammered out yet, and the folks who are negotiating it say they're still working on it.

The other option - or the other obstacle is this vote on drug importation. The idea being able - patients and pharmacists being able to purchase drugs from outside the U.S. at lower prices, and no vote has been set yet. So no agreement seems to have been reached on actually voting on the drug importation issue.

And lastly, this wasn't the last caucus. President Obama has summoned the whole caucus up to the White House tomorrow for another sort of rally and to talk about what their options are now that it seems like this compromise has fallen through.

BLOCK: Okay. NPR's Audie Cornish on Capitol Hill. Audie, thanks a lot.

CORNISH: Thank you.

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