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Controversial Changes in US Elder Health Program Become Law - 2003-12-08

Millions of senior citizens in the United States rely on a government program to subsidize their health care. Now that program, known as Medicare, is getting a costly and controversial overhaul. After years of political warfare in Washington, the most sweeping changes ever in the Medicare system have been signed into law.

Senior citizens have complained for years that Medicare does not pick up enough of their medical bills, particularly the high cost of prescription drugs. They say they worked hard and paid taxes for decades, only to watch their savings and pensions depleted by health care expenses.

Politicians tried and failed numerous times to reform the system. But they were unable to come up with a formula the government could afford. Finally, the Bush administration pushed its version through Congress. It was a big political win for the Republicans and the White House.

But as he signed the legislation, Mr. Bush called the passage of the bill a victory for America's seniors. "With this law, we are giving older Americans better choices and more control over their health care, so they can receive the modern medical care they deserve," he said.

This is the most far-reaching overhaul of Medicare since the program began in 1965, as part of the ambitious domestic agenda of then-President Lyndon Johnson. Though primarily designed to help the elderly, it also provides benefits to some Americans with disabilities.

The price tag for modernizing the program is huge: $400 billion over the next 10 years. As he prepared to sign the reform measure into law, in an auditorium filled with supporters, the president said it is worth the cost. "Our nation has the best health care system in the world, and we want our seniors to share in the benefits of that system. Our nation has made a promise, a solemn promise to America's seniors," he said. "We have pledged to help our citizens find affordable medical care in the later years of life."

Critics say the reform measure is flawed. They contend it is much too expensive, and does more to put money in the pockets of drug companies and health care providers than to help senior citizens.

Many Democrats in Congress, long the champions of the Medicare program created four decades ago by a Democratic president, are particularly incensed. They say the Republicans co-opted their issue, and pushed the legislation through with the 2004 election in mind, hoping that seniors will support President Bush's bid for another term in office.

Senior citizens form the most active voting bloc of any age group in the United States. They also comprise a large portion of the population in several states that could play a crucial role in next year's election, including Florida, the state that ultimately determined the outcome of the 2000 presidential race.