Perspective               

Details of Bush Medicare Plan Remains Unclear

Key features of President Bush's Medicare reform plan are still unclear several weeks after his State of the Union Address, in which he criticized "bureaucrats and trial lawyers and HMOs" for controlling health care. In the days after the address, the President said his Medicare plan would offer prescription drug coverage through HMOs and other private plans.

It remains uncertain whether President Bush's plan will also include prescription drug coverage under traditional Medicare, or if older and disabled adults would be forced to join private plans, such as HMOs, to get drug coverage. Consumer advocates contend that leaving older and disabled adults without the option of drug coverage under traditional Medicare would force them to decide between having access to the doctors and hospitals of their choice or getting their life-saving medications. Given that Presidents Bush wants to cut Medicare spending, it also remains unclear how much more he expects older and disabled adults to spend on their health care.

Moreover, President Bush appears to have some bargain basement version of the health care coverage available to federal employees in mind for people with Medicare. Policy experts project that it would cost the government $800 billion over seven years to provide older and disabled Americans with coverage comparable to that of federal employees, which is more than twice as much as President Bush is willing to pay. In addition, Don Young, president of the Health Insurance Association of America has said that private insurance companies do not offer a realistic path to providing a drug benefit to older and disabled Americans. In fact, Medicare was created because private plans could not make a profit providing health insurance to older adults or people with disabilities.

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