The House Wednesday soundly rejected a plan to cover long-term home health care under Medicare, respectfully applauding the measure's 87-year-old sponsor but siding with arguments its approval would have abused House procedure.
Shortly afterward, the Senate overwhelmingly cleared the first major expansion of Medicare since its 1965 inception, sending to President Reagan legislation to extend coverage to catastrophic health-care expenses.The House vote, technically to block debate of the home-care bill, was 243 to 169. The Senate voted 86 to 11 to pass the catastrophic-care legislation, a House-Senate compromise bill that cleared the House last week. The catastrophic-care bill, which passed both houses of Congress overwhelmingly in its final form, was considered fairly likely to be signed by Reagan despite reservations voiced by officials of the Office of Management and Budget.
Otis Bowen, secretary of health and human services, said he would ask Reagan to sign the legislation.
Some of the 11 Republicans who opposed the bill said it would unfairly require all the elderly to pay substantially for coverage few would qualify for.
The program, to be funded by added premiums paid by Medicare recipients themselves, is designed to cover the costs of the 7 percent of recipients who spend the most on hospital and doctor bills, and the 16.8 percent who spend the most on prescription drugs.
Scheduled to take effect on Jan. 1, the plan would cover the full cost of a hospital bill after payment of an annual $564 deductible. Doctor bills would be covered after payment of $1,370 a year. Half of prescription drug costs would be covered after payment of a $600 deductible.
Most long-term care costs for extended nursing home care, potentially the major health expense of most elderly citizens, are not covered, however. It was that absence that prompted Rep. Claude Pepper to introduce his home-care bill in the House. He said he would introduce it again in the next Congress.
House rejection of the home health-care proposal was a stinging defeat to Pepper, the Florida Democrat who chairs the House Rules Committee and had painted the bill as the capstone of a half-century career in Congress.
It also indicated most House members were concerned enough about costs _ an estimated $30 billion over five years _ and new taxes to risk offending elderly voters during an election year.
Funding for the entitlement was to come from eliminating the $45,000 cap on income subject to the 1.4 percent tax dedicated to Medicare.