Republicans still think H.R. 3590, the Patient Protection and Affordable Care Act bill, would hurt Medicare, and Democrats are still saying the bill would help Medicare.

Lawmakers returned to those themes this morning as they began a third day of debate of the PPACA bill on the PPACA bill.

There were no votes scheduled for this morning, but there could be votes on a women’s preventive health benefits amendment and a Medicare amendment that might be offered by Senate Majority Leader Harry Reid, D-Nev., sometime today.

The Senate also could vote on a motion by Sen. John McCain, R-Ariz., to send the bill back to the Senate Finance Committee for a rewrite, and it’s possible that senators could take up an amendment that would eliminate health insurers’ and medical malpractice insurers’ access to the McCarran-Ferguson Act antitrust exemption.

Sen. Robert Corker, R-Tenn., noted during a round of discussion that started about 9:30 a.m. that Medicare trustees expect the program to start running out of cash in 2017.

“We have a program that is insolvent,” Corker said.

In light of Medicare’s financial problems, implementing a PPACA bill provision that would cut Medicare funding $464 billion over 10 years is a bad idea, Corker said.

Sen. Samuel Brownback, R-Kan., also criticized the proposed Medicare cuts and echoed the observation of Sen. John McCain, R-Ariz., that the PPACA bill would cut hospice reimbursement funding.

McCain accused Democrats of taking funding from one insolvent health program to start another public health program.

Sen. Christopher Dodd, D-Conn., and Sen. Max Baucus, D-Mont., rose to defend the PPACA bill.

Dodd emphasized that AARP, Washington, has approved the bill.

Baucus distinguished between the benefits offered by the Medicare program and Medicare Advantage plan benefits.

“There are no Medicare cuts here” in H.R. 3590, Baucus said.

There may be cuts in extras such as the eyeglass benefits provided by Medicare Advantage plans, but “those aren’t Medicare plans,” Baucus said. “They’re private plans…. There’s a huge distinction between Medicare and these private insurance programs.”

The PPACA bill would add some basic Medicare benefits, would not cut any of the benefits promised by traditional Medicare, and would help push the anticipated Medicare insolvency date back to 2022, Baucus said.

Dodd reported cited estimates that a couple enrolled in the Medicare Part B physician insurance program pays about $90 per year in extra benefits to help absorb the cost of Medicare Advantage over-payments, even if the couple is not in a Medicare Advantage plan.

A few years ago, private insurers promised that they could offer Medicare Advantage plans for less than traditional Medicare if only they could come in and show the government how to run a health plan, according to Sen. Richard Durbin, D-Ill.

Funding for the Medicare Advantage program “really is a subsidy for the insurance companies,” said Sen. Sherrod Brown, D-Ohio.

Sen. Thomas Coburn, R-Okla., said Medicare Advantage is a benefits equalizer for people who cannot afford to buy Medicare supplement insurance to fill in the gaps in the traditional Medicare plan.

“What you’re taking away from the poorest of our elderly is the ability to have the same care that people who can afford Medicare supplement insurance get,” Coburn said.

Also during the morning session, Dodd countered Republican criticisms that the Democrats reduced the 10-year budget impact of the PPACA bill by not providing any new benefits until 2014.

The PPACA bill will create new health coverage tax breaks and many new consumer protection rules, such as bans on rescissions, as soon as it is signed into law, Dodd said.

For more coverage about the PPACA bill, see:

Note: If anything interesting happens this afternoon, we will cover that in another article.