NYTimes on the 1989 Repeal of the Medicaid Catastrophic Coverage Act

December 17th, 2013

Flash back to October 9, 1989, the New York Times has an article titled, “Retreat in Congress; The Catastrophic-Care Debacle – A special report.; How the New Medicare Law Fell on Hard Times in a Hurry“:

With the benefit of hindsight, legislators and policy makers in both parties now agree that the seeds of disaster for the Medicare Catastrophic Coverage Act were sown well before it became law barely a year ago.

Rarely has a Government program that promised so much to so many fallen apart so fast. The passage of the bill, in June 1988, was celebrated on both sides as a bipartisan success story in which the White House and the Congress teamed up to provide new medical benefits for the elderly: a ceiling on hospital and doctor bills, expanded payments for nursing home care and prescription drugs, and much more.

But it is now clear that the Reagan White House and the Democrats on Capitol Hill, acting on a set of flawed political calculations, combined to give the elderly ”too much, all at once, and we decided we were going to charge them for it,” in the words of Senator Dave Durenberger, Republican of Minnesota.

The problem was, people did not know what was in the bill, and when they found out, they didn’t like the price. Sound familiar?

The first rumblings of the revolt of the elderly were heard last November, at town meetings in California and Florida, retirement communities in the Southwest and campaign forums in Nevada.

”We found that despite all the discussion and all the media attention, many people were not aware of the legislation until it was enacted,” said Mr. Rother of the American Association of Retired Persons. ”Then they became aware of the price tag, without being aware of the benefits.”

But the supporters acknowledge that they too had a role in the program’s downfall. ”We failed to explain the bill well, and we needlessly complicated the financing by getting it involved in the tax code,” said Representative Fortney H. (Pete) Stark, the California Democrat who is chairman of the health subcommittee of the Ways and Means Committee.

Imagine that. People don’t like new, hidden taxes that make healthcare more expensive.

And who fixed it? John McCain?!

The Senate Finance Committee struggled vainly to find an acceptable compromise. In the end, Senator McCain, whom the bill’s supporters initially viewed as their archenemy, was the program’s savior. He designed a proposal to eliminate the surtax but retain the ceiling on hospital payments, which would be financed entirely by the monthly fee. His proposal, approved 99 to 0, staved off repeal.

Don’t forget this law was passed on a bipartisan basis, and signed by a Republican president. Unlike the ACA.

I should add that the Affordable Care Act, which was only passed through the Budget Reconciliation process because it was not subject to a 60-vote filibuster, can be repealed through the same process. You only need 50 votes and the White House.

H/T Mike B.