Health coverage options advanced by Dems

A top priority for the president
Numerous senior Democrats now aging and ailing have worked their entire careers on health care, but no one is more identified with the issue than Sen. Edward M. Kennedy, the Massachusetts Democrat first elected to the Senate in 1964. But in a poignant announcement during the day, Dodd said Kennedy, diagnosed a year ago with a brain tumor, will be unable to attend the working sessions of the health committee he chairs beginning next week.

Obama has made an overhaul of the health care system a top priority of his first year in office, both to assure coverage for the uninsured and also to slow the rate of growth in health care nationally. Outside groups representing hospitals, doctors, drug companies and others have pledged to work with the White House on that objective, but it is not clear how much money their efforts would yield in savings to the government.

That leaves lawmakers with the difficult chore of agreeing on a series of tax increases and spending reductions if they are to cover the costs of the legislation.

Obama met with a group of House Democrats at the White House during the day, and Orszag said the discussion centered on the administration's recent announcement that it is willing to try to find as much as $600 billion in Medicare savings, double what the president requested in his budget last winter.

"What I want to be very clear about is, at worst this will be deficit-neutral," the president said. "And then to the extent that these changes succeed in altering the practice of medicine in the way that experts have long believed that they will, the result will be much better than that."

Subsidies to help pay for insurance

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In both the House and Senate, Democrats want to provide subsidies to families with incomes of up to about $88,000 a year to help them pay for insurance.

House Democrats also are considering a wide-ranging change for Medicaid that would provide a uniform benefit across all 50 states and increase payments to providers, according to several officials. Medicaid is a joint state-federal program of health coverage for the poor.

The measure also envisions several changes to Medicare, the government program that provides health care to seniors, although details are lacking.

According to the outline, the gap between primary care physician fees and those of specialists would be narrowed, and beneficiaries would not incur out-of-pocket costs for preventive services. The outline also mentions unspecified improvements in the prescription drug benefit. Democrats vociferously opposed that benefit when Republicans passed it, saying it provided billions in unnecessary subsidies to pharmaceutical companies.

Part of the cost would be covered in the form of cuts in the government payments under Medicare plans run by private insurance companies, which receive more per patient than the cost of traditional coverage.

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