Alex's Outlook

Saturday, November 22, 2003

Medicare Expansion Wins in House

Over the past week, establishment Republicans, especially Newt Gingrich and Tom DeLay, had mounted a full-court press to convince wavering conservatives to vote for the party's $400 billion-plus expansion of Medicare.

On Saturday morning, it appeared that the Republican establishment's efforts were in vain. The House of Representatives had 216 votes in favor and 218 against the Medicare bill, with about 28 conservatives joining 190 Democrats in defeating the bill. In the wee hours of the morning, two conservatives switched sides; two Democrats then switched sides as well. The final tally was 220-215 in favor of the bill.

As a hardline conservative, I am ambivalent about the bill. Medicare gets a significant expansion (bad), but the Republicans got Health Savings Accounts, means-testing for higher-income seniors and pilot privatization programs in several areas of the country in return. For the HSAs alone I think the bill was worth passing, simply because if the bill were put off until 2004 the pressure to throw seniors a bone would be greater, and the Republicans would be all the more desperate to sign any bill to make themselves more "electable". The HSAs are a real step in the privatization direction. The pilot privatization program is a nice icing on the cake, but all others like it have failed in the past.

Finally, the bill doesn't kick in until 2006, so the Republicans can go back and edit it once they pad their majorities in November 2004.

A Medicare expansion was inevitable, and it could have been worse. It's not the fiscal cataclysm that some conservatives are making it out to be (unlike the energy bill).

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