Congress is prepraing for a final vote on one of this year's most anticipated pieces of legislation, the Medicare prescription drug bill.
New Hampshire's Congressmen are solidly behind the measure, but the state's two Senators have serious reservations.
The House of Representatives could vote on the bill as early as Friday.
New Hampshire Public Radio's Washington Correspondent Judith Smelser reports.
The long-awaited Medicare bill would add a prescription drug benefit to the popular government program.
First District Congressman Jeb Bradley says that's enough to win his vote.
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"It doesn't make a lot of sense to me that medicare covers heart disease or kidney disease and the surgery and hospitalization, but not the drugs that will prevent it. So this type of modernization will help senior citizens, do an awful lot more for preventative care, and I think make all of us healthier as we approach our golden years."
But there's plenty of opposition to the bill.
Congressional Democrats and some consumer groups say the prescription drug benefit is too expensive for seniors.
Medicare recipients would have to pay $35 dollars a month to participate in the plan.
There would also be a deductible of $275 dollars before the drug benefit would kick in.
Plus, the bill's opponents note, there would be no coverage at all for out of pocket drug costs between 2200 dollars and 3600 dollars.
Ron Pollack is the Executive Director of the healthcare consumer group Families USA.
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"This is what many people call a donut hole - it's really, better described, it's a chasm! // 6:09 People not only are not going to understand this because of its complexity, but when they hear about this huge chasm where they fall in and they don't get any help, people are going to be bewildered and upset."
The prescription drug benefit is only one of many provisions in the massive medicare bill.
Of particular interest to New Hampshire is a measure that would give around $25 billion dollars to rural health care providers.
Right now, medicare reimburses those providers at a lower rate than their urban counterparts.
Second District Congressman Charles Bass says that new funding is important to the Granite State.
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"The issue of increasing reimbursements to doctors and hospitals and home health care, nursing homes and so forth, in rural areas, which is extremely critical for New Hampshire - a no-vote on this bill means that those provider reimbursements will not occur."
But one of the bill's most contentious provisions involves allowing private health insurance plans to compete with the traditional medicare program.
Originally, the plan would've allowed the competitive system to take effect nationwide.
But because there was so much opposition to the idea, the conference committee decided to set up demonstration projects in six metropolitan areas.
But Congressman Bradley thinks it's a good idea to make medicare more competitive.
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"This will offer choice for senior citizens - the type of choice that I as a member of Congress have - for different providers of health insuraince, and I think that the six pilot programs that've been designed in this bill will give policymakers a lot of information as to how well this works."
He and Congressman Bass wish the nationwide plan could've been included in the final bill.
But opponents worry that seniors who stay in the traditional medicare program would see their premiums rise dramatically.
Ron Pollack with Families USA says that's because private plans would only accept the youngest and healthiest seniors.
He believes that eventually, older and sicker people - who have higher healthcare costs - would be the only ones left in traditional medicare.
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"The genius of the medicare program, currently, is that everyone who qualifies for medicare is in a pool, and it means that the oldest and the sickest - they get the benefit of being in a pool of younger and healthier people. The whole concept of insurance is that you spread the risk."
But Congressman Bass rejects that argument.
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"This is an old argument that's been used. It's a generic argument, if you will. The fact is that the plans will not be able to discriminate between one user and another user. They will either be offered to the medicare community or they will not be offered to the medicare community."
Despite the strong support of New Hampshire's Congressmen, the state's Senators are leaning against the medicare bill.
Judd Gregg and John Sununu have not yet announced how they'll vote on the bill, but both have expressed serious reservations.
For NHPR News, this is JS in Washington.
