Medicare conferees continue to work on the Medicare Prescription Drug legislation. However, there are still a number of disputed proposals, including premium support that would put traditional Medicare in direct competition with private plans beginning in 2010.

Conferees are also trying to reach agreement on ways to guarantee that spending on a drug benefit would not go beyond $400 billion set aside for the bill in the fiscal 2004 budget resolution.

The negotiators are also still sharply divided on two other issues. The first is whether consumers should be allowed to import drugs from foreign countries where they are often less expensive. The second is whether to create new health savings accounts, which would permit consumers to put aside money for medical expenses on a tax-free basis. These accounts would be available to all taxpayers, not just Medicare beneficiaries.

Congress has set an adjournment date of Nov. 21.

Several House GOP conservatives continue to repeat their insistence that premium suport and the health savings accounts be included in the final product and have told House Speaker Hastert that they will not support the final bill unless it includes these items.