Nevada senators vote against Medicare bill

Suzanne Struglinski

Tuesday, Nov. 25, 2003 | 9:24 a.m.

WASHINGTON -- President Bush was expected to address the Senate's approval of the major Medicare bill when he speaks in Las Vegas today, despite the no votes of Nevada's two senators.

By a 54-44 vote, the Senate passed the $400 billion bill that include plans for a prescription drug benefit for seniors on Medicare and other changes to the federal health care plan.

Nevada Sens. John Ensign, a Republican, and Harry Reid, a Democrat, voted against the bill. Reps. Jon Porter and Jim Gibbons, both R-Nev., voted for the bill in the House early Saturday while Rep. Shelley Berkley, D-Nev., opposed it.

Ensign announced his intention to vote against the bill late Monday, saying he "agonized" over the decision. He said there were "very good things in the bill" but that the cost estimates for it were too low.

"It threatens the fiscal security of the Medicare program" he said on the floor Monday. "The cost of this bill is grossly underestimated."

Ensign said the first 10 years are said to cost $400 billion but the 10 years after that are said to cost $1.7 trillion.

Ensign disagreed with the fact that seniors who would benefit from the new prescription drug benefit did not pay for when while they were working. It would be up to the young generation -- "you, me and our grandchildren" -- to pick up the tab for the drugs, he said.

Reid had problems with formulas in the bill he felt unfairly denied low-income seniors some benefits.

Bush and Health and Human Services Secretary Tommy Thompson had been pushing for the bill's approval, saying that while the legislation was not perfect it needed to be done this year.

Thompson said the president will talk about the bill in Las Vegas and Phoenix today. Bush was scheduled to speak at Spring Valley Hospital early today to talk about Medicare and medical liability issues, although the White House would not release specific information on his remarks prior to the event.

White House spokeswoman Claire Buchan said Monday that his remarks would reflect what happened on Capitol Hill.

"It's a very good bill," Thompson told the Sun Monday. "We believe it is very good public policy."

Thompson said Congress had to make the bill fit into the $400 billion limit and that the administration wanted to make sure it took care of low-income seniors first. The bill will cost $40 billion a year over the next 10 years.

"It's a wonderful things for low-income American seniors," he said.

Just under 24,000 seniors in Nevada will qualify for reduced premiums and no gaps in coverage, according to the department.

Reid and Berkley did not like a proposed pilot program planned for 2010 that will select cities to demonstrate a private competition of using Medicare and regular health plans such as PPOs, HMOs, or the regular fee-for-service Medicare plan.

"Everyone wonders which will be most efficient," Thompson said.

To determine this, the selected cities will compare the plans over six years.

Asked if Las Vegas will be a selected city, Thompson said, "Who knows?"

Selection won't take place until 2009, when Thompson said he "won't be around."

He said of the six cities, one will have to be from the four most populous metropolitan service areas, one from the four least populated, one from a service area that covers more than one state and no more than two can be from any one region of the country. Las Vegas fits two of those criteria.