The House voted overwhelmingly Thursday to eliminate monthly premium increases for millions of Medicare patients next year.
It voted 406 to 18 to send the bill to the Senate, which is expected to act soon. Lawmakers said older Americans shouldn't have to pay higher Medicare Part B premiums because they are not expected to get a cost of living increase from Social Security.
The vast majority of Medicare recipients already are exempt from Part B premium increases because of a hold-harmless provision that kicks in when there is no increase in Social Security.
Still, several million would face monthly premium increases of $8 to $23, without congressional action. The standard monthly premium is $96.40 this year.
House Majority Leader Steny Hoyer of Maryland, in a rare break with fellow Democrats, voted against the measure, saying it would mainly help wealthy Medicare recipients.
"If we take care of everybody, we won't be able to take care of those who need us most," Hoyer said.
About 42 million seniors and people with disabilities are enrolled in Medicare Part B, which provides coverage for doctor's visits. By law, about three-fourths are exempt from premium increases when there is no increase in Social Security payments.
The Social Security Administration projects no cost-of-living increases for the next two years because the adjustments are pegged to inflation, which has been negative this year, largely because energy prices are below 2008 levels.
Most of the 11 million or so patients who are not exempt from premium increases are low-income people who also qualify for Medicaid. Medicaid, the state-federal health insurance program for the poor, pays their Medicare premiums, meaning states would bear some of the costs.
Among the rest who are not exempt, a little more than 2 million are high-income seniors — singles making more than $85,000 a year and couples making more than $170,000. Also, about 1.3 million new enrollees would not be exempt.
Without congressional action, the Medicare trustees have projected that standard Medicare Part B premiums would go from $96.40 a month this year to $104.20 a month in 2010. The Congressional Budget Office projects premiums could go to $119.40.
The House bill would eliminate all Part B premium increases, using $2.8 billion in other Medicare funding. Democrats said they had to act on a bill quickly so the administration could set premium rates for next year and inform seniors this fall.
Republican lawmakers complained about the short notice of the vote. The bill was unveiled Wednesday and a vote was scheduled for a day later, with no public hearings.
"Why couldn't we have held a hearing on this and marked the bill up in the month that we've been back?" said Rep. Joe Barton, R-Texas.
Democrats said a recession is a bad time to increase Medicare premiums for any seniors, especially when their Social Security payments are frozen.
"Especially given the state of the economy, we must act to ensure that all seniors are treated fairly," said Rep. Henry Waxman, D-Calif., chairman of the House Energy and Commerce Committee, which oversees Medicare.