The Senate was unable to garner enough support to approve a prescription drug benefit for seniors through Medicare. Just before its August recess, the Senate rejected a bipartisan bill proposed by Sens. Bob Graham (D-Fla.) and Gordon Smith (R-Ore.) that offered a stripped-down prescription drug plan that would benefit low-income seniors or those who face "catastrophic" drug costs.

The measure was a departure from the Democrat's plan for a more comprehensive benefit to cover all senior citizens as well as a Republican plan that relied on private insurers. It failed by a 49-50 vote, 11 votes shy of the 60 needed to pass the Senate.

In July, the Senate voted down a Democratic plan that would expand Medicare--the nation's largest health insurance program--to offer prescription drug coverage to older Americans, including low deductibles and a flat co-payment for drugs. It also rejected a Republican proposal that focused on subsidies for private health companies to offer drug coverage.

The Graham-Smith proposal was an amendment to a drug bill (S.812) crafted to make it easier for generic drug competitors to compete by limiting patent extensions for drug companies. That bill, which was sponsored by Sen. Charles E. Schumer (D-N.Y.), was approved 78-21. It could save an estimated $60 billion in drug costs over the next 10 years, according to the Congressional Budget Office.

"We were counting on the Senate to enact a comprehensive and affordable Medicare prescription drug benefit," said AFT president Sandra Feldman, "and we are extremely disappointed that the Senate leadership's bill, supported by a majority of senators, was blocked by a largely partisan procedural vote. The AFT will continue to fight for a prescription drug benefit under Medicare that is affordable to seniors, protects them against high drug costs and is not subject to the whims of private insurers."

AFT retiree Jeanne Boone is thankful for the prescription drug benefit negotiated by the Philadelphia Federation of Teachers. Even though she pays more than $600 for it, that's more acceptable than the state's plan for retirees, said Boone, who said she would have had to pay significantly more for her prescriptions under the state's plan. "I'm grateful [for the union-negotiated benefit], considering the alternative."

Last year, PFT's Health and Welfare Fund spent $4 million on prescription drugs for retirees, said Boone, who is a past president for the PFT retiree chapter.

Congress could return to the issue of prescription drugs in September but it would be an uphill fight to get something passed.

Home healthcare workers are waiting anxiously on Congress to decide whether it will eliminate a 15 percent cut in home health support from Medicare scheduled to take place in October 2002. If the cut goes through as planned, it would "force many home healthcare agencies to close, leaving many of those who depend on them fighting for their very lives," the AFT said in a June 19 letter to the members of the Senate Committee on Finance. The letter asks the Senate to repeal the cut.

"Home health care spending has already been rolled back significantly," says Anne Goldman, special representative for the Federation of Nurses, which is part of the United Federation of Teachers in New York City. "It's already bare bones. We deal with a chronic population, if we can't accommodate them they are going into nursing homes and hospitals."

In 1997, Congress agreed to establish cost-saving measures in Medicare, set by the Balanced Budget Act of 1997, which included reduced payments to hospitals and home health agencies. The goal of reducing Medicare spending has been surpassed and Congress has twice issued one-year delays to restore some of the cuts.

A study by the American Association for Healthcare shows that Medicare home health spending dropped significantly since 1997. Spending fell from $16.8 billion in 1996 to $9 billion in 2000. During that same period, visits by home health workers declined by more than 50 percent and the number of beneficiaries dropped 24 percent. According to the study, "any additional cut in payments for Medicare home health services risks exacerbating the access concerns and possibly further jeopardizes the quality of services for the most vulnerable beneficiaries."

In New York City, where the decades old Visiting Nurse Service of New York (VNSNY) delivers home health care that ranges from pediatrics to elder care psychiatric assessments to AIDS treatment, short-term interventions to long-term management, home health nurses are worried.

A cut in Medicare spending would "seriously impact" home health services, says Jo Ann Adams, a member of the Federation of Nurses/UFT and a Visiting Nurse Service chapter representative. Any reduction in funds means that "something has to give," says Adams. She believes hat "something" will be patient care.

Nurses will lose precious time with their patients, says Adams. It would mean less time for teaching them about taking care of themselves or talking about their concerns, she adds. "It takes time to develop a trust. It doesn't develop overnight and it can't be done if we're rushed in and rushed out."

American Federation of Teachers, AFL•CIO - 555 New Jersey Avenue, NW - Washington, DC 20001