Image: Frist Speaks About Medicare Legislation At The Capitol
Senate Majority Leader Bill Frist, center, speaks to reporters at the Capitol on Monday. Joining Frist from left are Sens. Chuck Grassley, R-Iowa, John Breaux, D-La.. and and Max Baucus, D-Mont.
updated 11/24/2003 5:45:23 AM ET 2003-11-24T10:45:23

The Senate voted to choke off debate Monday on a historic Medicare prescription drug bill, but die-hard opponents vowed one final effort to scuttle the legislation they attacked as a boon to pharmaceutical and insurance industries.

THE VOTE was 70-29, 10 votes more than the 60 needed to end a filibuster led by Sen. Edward M. Kennedy, D-Mass., and joined by a pair of Democratic presidential hopefuls eager to share the spotlight.

“Today is a momentous and historic day,” said Senate Majority Leader Bill Frist, R-Tenn., who accused opponents of resorting to “procedural tricks to obstruct” passage of legislation making the most sweeping changes in Medicare since the program’s creation in 1965.

“The Senate is on trial,” thundered Kennedy. “Let us not turn our backs on our senior citizens so insurance companies and pharmaceutical companies can charge senior citizens even higher prices.”

Despite the outcome of the first vote, the bill’s supporters expressed concern about a second procedural vote, expected later in the day. It, too, would require them to amass 60 votes to advance the bill to final passage.

PROVISIONS OF THE BILL

The bill would provide a prescription drug benefit for Medicare beneficiaries for the first time since the giant health care program for seniors was created in 1965, with subsidies to help lower-income seniors pay the premiums and other costs.

It also would provide subsidies to insurance companies in hopes they would offer private coverage to seniors — a provision viewed with favor by conservatives but suspicion by many Democrats.

After years of gridlock and months of struggle, the bill’s supporters claimed they would gain the 60 votes they needed to prevail on the first in a series of test votes expected during the day. Opponents did not challenge that, but said they hoped to erect more challenging hurdles.

The bill cleared the House in a pre-dawn, 220-215 vote Saturday. Senate passage would send it to President Bush, who is eager to sign it into law.

Nine Democrats announced plans to support the measure, as did Sen. James Jeffords, a Vermont independent. But even with the support of all 10, Republicans could afford to lose only one GOP vote to be assured of prevailing on the second test vote.

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The bill’s most vocal opponent has been Kennedy, but some Democratic presidential hopefuls sought a share of the spotlight.

“This bill is really about President Bush passing the buck on prescription drug coverage and passing the bucks from seniors to the pharmaceutical industry,” said Massachusetts Sen. John Kerry, who scrapped a series of campaign events to return to the Capitol for his speech and the votes.

Sen. John Edwards of North Carolina likewise flew to Washington, eager to join the fight. “We need to stand up to drug companies and HMOs and stand up for the American people,” he said on the Senate floor.

Sen. Joseph Lieberman of Connecticut also announced his opposition to the measure, and was expected in the Senate for the day’s votes.

KENNEDY, DASCHLE LEAD OPPOSITION

Despite efforts led by Kennedy and Democratic Leader Tom Daschle of South Dakota to scuttle the bill, the list of Democratic supporters grew during the day, and strategists said it was likely to grow again before the final vote was called.

Sens. Dianne Feinstein of California and Ron Wyden of Oregon announced they would vote for the bill, bringing the number of announced Democratic supporters to nine. Republicans control the Senate 51-48 with one independent.

In her speech, Feinstein catalogued a series of provisions that would provide additional funding for her home state, adding: “I intend to support this bill, and not because it is perfect, but because I believe it brings substantial help to people who need that help in my state of California.”

Wyden, too, described the bill as something of a mixed blessing. On balance, he said he had decided to vote for it, but call his decision a “very, very tough call.”

Republicans expect only a handful of defections among GOP members.

The far-reaching bill would increase Medicare funding for doctors, hospitals and other health care providers, particularly in rural areas, where reimbursement levels are far below what is paid in other regions of the country. It also provides billions of dollars to companies to encourage them to retain the health coverage they provide their retirees.

For the first time, higher-earning seniors would be required to pay more for their Medicare Part B premiums than other beneficiaries. The measure also retains the current ban on the importation of lower-cost prescription drugs from Canada, and establishes tax-preferred health savings accounts for individuals with high-deductible insurance coverage.

The most contentious provision would take effect in 2010, when direct competition between traditional Medicare and the private plans begins in up to six metropolitan areas. Supporters argue that would help reduce the cost of Medicare in the long run, while opponents attack it as the leading edge of an effort by Republicans to privatize the system.

© 2003 Associated Press. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.

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