WASHINGTON – While the national vote was not so clear-cut, Maryland’s congressional delegation split cleanly along party lines on a bill that would reform Medicare while providing prescription drug coverage for the first time.
None of the Maryland Democrats in Congress — six House members and both senators — supported the Republican-drafted legislation, even though 16 House Democrats and 11 Senate Democrats from other states crossed party lines.
And despite a conservative outcry over the bill’s $400 billion estimated cost that caused some Republicans to balk, both of Maryland’s two GOP House members voted for the bill.
The bill passed the House 220-215 in a vote early Saturday and it passed the Senate 54-44 in a vote Tuesday. President Bush is expected to sign it.
“This is a great, great step forward for health care coverage,” said Rep. Wayne Gilchrest, R-Kennedyville.
But Sen. Barbara Mikulski, D-Baltimore, said it was “a step, but in the wrong direction.”
“If you take the wrong step, you can fall flat on your face,” Mikulski said Monday on the floor of the Senate.
Among other changes, the bill would provide higher reimbursement rates for medical services in rural areas, such as the Eastern Shore that makes up the bulk of Gilchrest’s district and the Western Maryland counties of Rep. Roscoe Bartlett, R-Frederick. Many of the Democrats who voted for the bill also are from rural areas.
But Gilchrest pointed to a Centers for Medicare and Medicaid Services study that said the legislation would save Maryland $354 million over eight years by shifting drug costs from Medicaid, which is state-funded, to Medicare, which is federally funded. More than 76,000 seniors in Maryland qualify for both programs.
Nationally, 25 conservative Republicans broke with their party and voted against the bill largely because of the cost. The House Republican leadership kept the vote open for nearly three hours Saturday until they could get enough votes to pass the bill.
But Bartlett, a fiscal conservative, supported the bill largely because it would allow competition from private health care companies. That would give seniors more choices and control over how Medicare funds are spent, said his spokeswoman, Lisa Wright.
The new program would not bankrupt Medicare because “the American people are wise enough to take advantage of these market forces,” Bartlett said.
But Maryland Democrats said private competition would threaten the future of Medicare. Mikulski said she would not support any plan that “helped the insurance companies instead of seniors.”
Rep. Steny Hoyer, D-Mechanicsville, warned that Maryland seniors “are now going to learn about some of the harmful provisions” of the bill. Hoyer, the House minority whip, argued that the bill was not a good “first step,” as proponents call it, because the harm outweighed the good.
Mikulski acknowledged that many seniors have gotten impatient for Congress to pass Medicare prescription drug coverage, which lawmakers have failed to do for years. But she said that not only is the prescription drug coverage in the bill inadequate, it will not make up for the harm from the other changes.
“Senior citizens in Maryland have told me they don’t even buy green bananas. They don’t want to wait,” Mikulski said. But “I want to give [them] something real.”