Medicare measures clear Congress, but Senate-House compromise is far off

? The top Republican leaders in Congress dampened talk of a quick compromise on legislation to remake Medicare Friday as they confronted issues ranging from the details of a prescription drug benefit to proposed free market measures and a dispute over lower-cost generic drugs.

With talks expected to begin next month, Senate Majority Leader Bill Frist, R-Tenn., and Speaker Dennis Hastert, R-Ill., both said they wanted the final compromise to require affluent senior citizens to pay more for their Medicare.

“We have a mandate to do so,” said Frist, referring to the Senate’s strong signal of support Thursday night for a plan to charge higher-income seniors a larger premium for doctor and nonhospital services under existing Medicare.

The House legislation envisions higher prescription drug costs for some upper income seniors, and Hastert said it “should be in there, so someone who makes $60,000 is going to get a different benefit than someone who makes $100,000.”

Both houses approved bills early Friday in remarkable post-midnight sessions at opposite ends of the Capitol.

“We got it done. Sometimes it’s pretty, sometimes it ain’t,” shrugged Hastert, who held open the final House roll call for nearly an hour, until nearly 2:45 a.m., so he could scrounge up enough votes to pass the GOP-backed measure.

In the end, Rep. C.L. Otter, R-Idaho, and Jo Ann Emerson, R-Mo., switched their votes from opposition to support, and the measure passed, 216-215. Emerson’s decision sealed passage after Hastert and other Republicans had lobbied her intensely toward the rear of the chamber.