On August 18^th, John Kotson, Ed Bettinardi and Hazel Floyd traveled to Cheyenne, Wyoming for a video conference with Wyoming Senator Mike Enzi’s Washington Senior Staff Advisor, Katie Barr. Katie serves on the Senate HELP (Health, Education, Labor and Pensions) Committee under Health Policy. The meeting was set up by Hazel, working with Enzi’s local office in Cheyenne. Senator Enzi is very important since he serves on both the Senate HELP and Finance Committees and is a member of the “Gang of Six” currently negotiating health care reform in the Senate.

John Kotson presented the highlights from the white paper on Medicare catastrophic care and Ed and Hazel joined in discussion of the subject. Katie was very knowledgeable on the overall health care issue and the contents of both the Senate HELP and Finance health care reform bills. She had read the white paper and was familiar with the CBO Option 81 that describes a methodology for implementing Medicare catastrophic care while saving the overall program money.

Katie stated that Medicare catastrophic care was under consideration by Senator Enzi and his staff. They were sensitive to the idea that catastrophic care should not be offered to only a portion of the people. She stated that the Senate HELP bill currently limits annual out-of-pocket costs to $6,000 per individual and $12,000 per family, but they realized that persons over 65 were left out.

They were also concerned that people would rebel against the higher deductible needed to implement the CBO Option 81. It was suggested that catastrophic care could be offered as an option to Medicare recipients and she liked that idea. She also stated that AARP was against option 81. We told her that AARP might be suffering from a conflict of interest since Medicare supplemental insurance is a big money maker for AARP. She agreed, stating that “we were preaching to the choir”.

Ed queried her at some length about the progress of the Senate bills. She directed us to a summary of the Senate HELP bill and said she would mail it to Enzi’s Cheyenne office. Hazel will follow up to obtain a copy for our use. She also stated that even if Enzi did not support the final Senate health care reform bill, they would consider implementing Medicare catastrophic care through other avenues.

Overall it was an excellent meeting. We have seldom encountered a staff person as knowledgeable as Katie and willing to work with us on the issue of Medicare catastrophic coverage. Perhaps there is hope yet.

RMAC Health Care Committee