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House heads for Medicare drug vote,,

Democrats and House Republicans who threaten prospects for passage in either chamber.

Frist predicted the Senate may vote on the proposal Monday. As initially drafted, the compromise came in at $395 billion over the next decade, $5 billion less than the amount set aside for the package under the fiscal 2004 budget outline, according to a Congressional Budget Office analysis.

That gave the plan's drafters room to sweeten the proposed drug benefit in a bid to further build support. Among the changes, the proposed deductible for drug coverage was lowered from $275 to $250.

That means the drug bill would cover 75 percent of drug costs between $250 and $2,250. The earlier draft had cut off coverage at $2,200.

Catastrophic coverage would kick in once out-of-pocket spending exceeded $3,600, covering 95 percent of costs. The drug benefit would become available in 2006. Meanwhile, prescription drug discount cards would be available to all Medicare beneficiaries beginning in April 2004. Beneficiaries who opt to participate in the plan would pay a monthly premium of $35. The drug plan is voluntary. Seniors would be able to buy prescriptions through a private drug plan or could leave Medicare and join a preferred-provider organization. In either case, premiums, coverage levels and deductible would be the same. House and Senate Democrats, who complained they were kept out of the talks, have attacked provisions that would establish a test project requiring the traditional Medicare fee-for-service program to compete with private plans in six metropolitan areas and one region of the country beginning in 2010. That proposal has also drawn criticism from conservative House Republicans, who say it doesn't go far enough. The original House bill called for Medicare to compete directly with private health plans beginning in 2010. The Senate bill contained no such provision, known as "premium support." Such proposals
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