By Amy Goldstein
Washington Post Staff Writer
Thursday, October 16, 2003; Page A01
House and Senate negotiators, struggling for accord on a plan to redesign Medicare, have agreed in principle that wealthy older Americans should pay more for doctor visits and other outpatient care, reprising an idea that has proved politically explosive.
According to several sources familiar with the negotiations, the core group of lawmakers trying to resolve separate House and Senate versions of the Medicare legislation has reached consensus on the basic strategy of charging higher insurance premiums to recipients with comparatively high incomes.
The negotiators, however, have not worked out crucial questions such as how many of Medicare's 40 million recipients would pay such a surcharge, when it would begin and how the government would administer it. "The details are still very much up in the air," said one source, although negotiators have reached a "general consensus."
The agreement's basic contours, reached during a bargaining session yesterday, would take Medicare in a direction not envisioned by the House or the Senate in June, when each chamber passed legislation to add a prescription drug benefit and a larger role for private health plans to the insurance program for the elderly and disabled.
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http://www.washingtonpost.com/wp-dyn/articles/A32445-2003Oct15.html