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Democrats Enter Medicare Field With Game Plan

Minority party pushes for more health-care choices for poor seniors, without raising fees

THE battle over Medicare has been fully joined now that Democrats have lobbed an alternative proposal to reform Medicare, the nation's health-care program for the elderly.

Charging that Republicans were seeking massive cuts in the program in order to pay for a $245 billion package of tax cuts to the wealthy, Democrats outlined their own plan to preserve benefits to the elderly without raising the cost of recipient's premiums.

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How to keep Medicare solvent into the next century is perhaps the most pivotal debate on Capitol Hill, with the future control of Congress - some Republican analysts say - hanging in the balance. While the new plan is unlikely to receive much of an open hearing, it nonetheless underscores the stakes for both parties as the 1996 election cycle nears.

Republicans provoked new veto threats from President Clinton over the weekend when a Senate panel voted 11 to 9 along party lines to curb the growth of Medicare by $70 billion. The bill also called for $182 billion in savings from Medicaid, the health-care plan for the poor, and $42 billion in savings from reforms to the Earned Income Tax Credit, a break for low-income families.

Like the Republican plan to reform Medicare, the Democrats' plan promises to keep the program solvent into the next century. But it bases its reforms on recommendations by the Medicare Trust Fund trustees that $89 billion, not $270 billion, is all that is necessary in savings over seven years.

Unlike the Republican bill, the Democrats vowed not to raise the payments, copayments, or deductibles of recipients. The GOP would increase premiums by $7 a month, higher for wealthier recipients. Both plans affect the payments of providers.

More choice

The Democratic plan would offer seniors choice in care by introducing new types of private health-care plans. Instead of being limited to a preselected group of Health Maintenance Organizations, or HMOs, seniors would be able to chose among a wider range of providers and would be given report cards on those providers to help them select.

The Democrats also proposed to crack down on fraud by imposing penalties and earmarked $200 million from the Medicare Trust Fund on an annual basis to facilitate antifraud efforts. They claimed that they would save $10 for every $1 invested in the program by curbing abuse.

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Fightin' words

The debate over Medicare and Medicaid is characterized by charged rhetoric from both sides of the aisle.

White House chief of staff Leon Panetta told reporters over the weekend, for example, that ''House Republicans are seeking to repeal protections for older Americans signed into law by Ronald Reagan that were designed to prevent the elderly from being forced into poverty - and even having their homes taken away - so that a husband or wife could get needed nursing home care.''

Republicans call such talk ''demagoguery, medigoguery, mediscare,'' in the words of Sen. Bill Frist (R), a freshman from Tennessee.

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