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Executive Summary

The Senate Finance Committee should review the Medicare Catastrophic Care Act, "especially including the financing mechanism," according to a resolution passed by the Senate on April 12 in a 97-2 vote. The "sense of the Senate" resolution, which is nonbinding, was added as an amendment to the Minimum Wage Restoration Act. The amendment was sponsored by Sen. Nickles (R-Okla.). "It is the sense of the Senate that the Senate Finance Committee review . . . the Medicare Catastrophic Coverage Act of 1988 . . . Be it further the sense of the Senate that the Finance Committee hold hearings in the process of reviewing [the act]," the amendment concludes. "According to the Health Insurance Association of America, at least 70% of the elderly were covered by the supplemental insurance policies (sometimes provided by former employers) or Medicaid at the time [the act] was enacted, in effect, duplicating some coverage for almost two-thirds of the Medicare beneficiaries," the resolution states. The amendment also addresses the added tax liability created by the act and notes that "hundreds of thousands" of senior citizens have requested their representatives to revise the bill. In a floor speech supporting the resolution, Nickles suggested the act be modified to "direct the catastrophic coverage to those people who did not have coverage before and to those people who could not afford it." Finance Committee Chairman Bentsen (D-Tex.), defending the act, said he planned "all along" to have oversight hearings on the legislation. "That is what we ought to do, in the case of any major new social legislation," he added. "That is the normal process." Noting that the act cleared the Senate last year by an 86-11 margin, Bentsen called the law "a major step forward in health care for senior citizens of this country." The two dissenting votes were cast by Sens. Durenberger (R-Minn.) and Rudman (R-N.H.). Durenberger commented on the floor that he was "troubled by the implication behind this resolution that [provisions of the act], which took many difficult months to develop and enact into law, would be subject to reopening at this early stage." Further, Durenberger said, the resolution "is of particular concern to me because similar and perhaps even more intractable issues are soon to be confronted by myself and other members of the Congressional Bipartisan Commission on Comprehensive Health Care. The work of the Commission would be sorely handicapped if the most fundamental tenets of fiscally responsible approaches were viewed as being off limits as we begin our deliberations." The commission, on which Durenberger is a vice chairman, was established under the Catastrophic Care Act to develop a strategy for providing health insurance for the uninsured and devising plans for long-term care coverage. During an April 11 House Commerce/Health Subcommittee markup of a bill to modify the leadership structure of the Bipartisan Commission, an amendment was offered by Rep. Bilirakis (R-Fla.) to repeal or revise certain provisions of the Catastrophic Care Act. Subcommittee Chairman Waxman (D-Calif.) ruled that the amendment was not germane because the bill under consideration focused only on a section of the Catastrophic Care Act, not on the entire law. Rep. Dannemeyer (R-Calif.) called for an appeal of Waxman's ruling but was defeated on a party-line vote. Bilirakis requested that Waxman consider scheduling hearings on the Medicare expansion law.

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