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Medicare a Flashpoint in Health Debate

Benefits for seniors on Medicare emerged as a flashpoint Thursday as senators writing a sweeping health care overhaul began their third day of slow-moving deliberations with tempers flaring.

The Senate Finance Committee voted 13-10 along party lines to reject an amendment by Sen. Orrin Hatch, R-Utah, that would have delayed coverage for the uninsured if a million or more people who now have insurance wound up having to pay higher premiums as a result of the legislation.

Hatch said his amendment was intended to protect seniors who signed up for private insurance plans through Medicare and could lose some benefits as a result of cuts to the commercial plans. About 10 million seniors are now signed up through the private plans, about one-fourth of Medicare recipients. The 'Medicare Advantage' plans can offer enhanced benefits because the government pays them more than it costs to care for seniors in traditional Medicare. Special Report: Health Care

A series of amendments on the issue are expected throughout the day, including a Democratic alternative from Florida Sen. Bill Nelson that would shield seniors currently in private plans from the cuts.

Tempers flared when Chairman Max Baucus, D-Mont., told Sen. Jon Kyl, R-Ariz., to hurry up and finish a point he was trying to make. Kyl raised his voice, protesting, and another senator appealed for calm.

Additional, difficult challenges are certain as Baucus tries to shepherd the measure through toward a vote this fall in the full Senate.

Nelson, D-Fla., told reporters Wednesday night he hopes to sweeten Medicare prescription drug benefits and lay the costs off on the pharmaceutical industry, a change that threatens to undermine an agreement that the White House and Baucus struck months ago with drug companies.

Other committee members want to ease cuts in future payments to hospice, home health care and other service providers under Medicare, a key source of funding for the legislation.

And Sen. Kent Conrad, D-N.D., said additional work needs to be done to make insurance more affordable for lower-income families.

With polls showing seniors are skeptical about Obama's call for legislation, Democrats said the bill included numerous provisions to enhance benefits under Medicare, and Baucus said it would improve the solvency of the financially strained Medicare trust fund.

The Finance Committee is the last of five congressional panels to debate health care legislation that is atop Obama's domestic agenda. While the bill omits several provisions backed by liberals, Baucus hopes to hold support from all Democrats on the panel, and perhaps pick up support from Republican Sen. Olympia Snowe of Maine as well.

Snowe has yet to disclose her intentions, and while she sometimes sided with fellow Republicans during the day, she also voted with Democrats at other points.

At its core, the bill is designed to expand health insurance coverage to millions of people who lack it, employing a new system of federal subsidies for lower-income individuals and families and establishing an insurance exchange in which coverage would have federally guaranteed benefits. Insurance companies would be prohibited from refusing to sell insurance based on an individual's health history, and limits would be imposed on higher premiums based on age.

At the same time, Baucus - in keeping with Obama's wishes - drafted legislation that would reduce the skyrocketing rate of medical spending overall. The bill's price tag is less than $900 billion over a decade.

Legislation already has cleared three committees in the House, and the leadership is slowly piecing together changes that could lead to a vote next month.

Senate Majority Leader Harry Reid, D-Nev., has said he intends to bring legislation to the Senate floor as soon as possible.

Whatever measure emerges from the Finance Committee must be blended with a bill that cleared the Senate Health, Education, Labor and Pensions Committee several weeks ago.

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