Owens weighs several aspects of House bill

WASHINGTON — Rep. William L. Owens had scarcely voted for health care reform before critics started complaining that he broke a campaign promise not to support cuts in Medicare benefits.

But whether he technically kept his word remains to be seen, even though the bill approved by the House clearly cuts Medicare to help pay for an additional government-run health care program for people who cannot obtain private insurance.

"This bill doesn't weaken Medicare. It strengthens it," Mr. Owens said Sunday, reflecting on one of many aspects of the bill he considered in voting for it late Saturday.

The key is the word "benefits," because the Democratic-sponsored measure finds other sources within the program to tap a few hundred billion dollars — while closing the so-called doughnut hole in Medicare Part D coverage that occurs when annual drug costs exceed $2,700 but are less than $6,154, a goal both Republicans and Democrats have sought since the GOP-led Congress expanded Medicare several years ago.

But analysts say that some elderly beneficiaries of Medicare Advantage, which is administered by private companies, may indeed see a small drop in benefits, such as a gym membership or a pair of eyeglasses. The nonpartisan Web site Factcheck.org called Republican portrayals of massive cuts "outright false," but acknowledged the possible effects on Medicare Advantage benefits.

The charges over Medicare in the health bill debate mark one of the political minefields for Mr. Owens as he tries to turn his narrow victory in last week's special election into solid enough support to win re-election next year in a likely less fractured race. But while he said he is "comfortable" with the House version's Medicare provision, he is still looking for some changes in the final version.

Ultimately, a House-Senate conference committee will decide the final product — once the Senate passes its bill, perhaps before year's end.

Mr. Owens said he would like to exempt companies with payrolls up to $750,000 from the requirement to provide employees with insurance, instead of the $500,000 limit in the House bill. And he said he is studying a tax credit provision to be sure that forest product companies, an important business in the Adirondacks, are not somehow penalized.

While some lawmakers from rural states say they are concerned the legislation does not solve their main worry, access to quality care and affordable insurance, Mr. Owens said that simply covering more people will help by reducing emergency room visits and that the legislation creates incentives for more doctors to practice in underserved areas.

The legislation boosts programs meant to draw more doctors to rural areas, such as college loan forgiveness, and was endorsed by the Center for Rural Affairs, a group based in the Plains and Upper Midwest that focuses on public policy's effects on rural America.

Still, the reform effort faces some of its toughest challenges in rural areas. Many of the Democrats who have voiced opposition or reluctance are from such areas.

After a late night voting on the bill Saturday, Mr. Owens returned to the north country Sunday.

His sales pitch for the bill: It does not raise taxes on the middle class, although the wealthy will pay a surcharge, and tinsurance companies no longer will be able to deny coverage to people with pre-existing conditions.

"We want to tell people that many, many more people will be covered," Mr. Owens said.