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Medicare News
Changes to Medicare Pulled from SCHIP Bill by
Negotiators
Democrats vow to make another run at changes to
Medicare
 Sept. 19, 2007 Democrats, particularly in the
House, made a bold attempt to make significant changes in Medicare as
part of the bill to reauthorize and expand SCHIP, the federal program
providing health insurance to lower income children. Those changes to
Medicare were tossed by the Senate and House negotiators, but some
Democrats say they will bring them up again.
SCHIP Compromise Bill Unlikely
To Include Medicare Revisions
Congressional negotiators have agreed not to
include revisions to Medicare in compromise SCHIP legislation that would
reauthorize and expand the program, and lawmakers could vote on
compromise legislation next week, CongressDaily reports (Johnson,
CongressDaily, 9/19).
The draft compromise bill, announced on Sunday,
closely resembles the Senate version of SCHIP legislation, which would
provide an additional $35 billion in funding over the next five years
and bring total spending on the program to $60 billion. The additional
funding would be paid for by an increase in the tobacco tax, which would
be similar to the 61-cent-per-pack tax proposed in the Senate version (Kaiser
Daily Health Policy Report, 9/18).
The compromise bill does not include provisions of
the House bill that would reduce payments to Medicare Advantage plans to
help fund an expansion of the program, leaving a cigarette tax increase
as the primary funding source for the legislation. However, a greater
cigarette tax increase than was included in the House SCHIP legislation
is "riling many members of Congress from tobacco-producing states,"
according to the
Washington Times.
Sen. Jim Bunning (R-Ky.) said that under the
proposed tax increase, Kentucky would pay $602 million more in tobacco
taxes over five years than it would receive in SCHIP funds. California
would receive $2.5 billion more in SCHIP funding than what it would
spend on the tobacco tax, according to Bunning (Lengell, Washington
Times, 9/19).
In addition, some House Democrats "have bristled"
at being asked to separate the Medicare revisions, according to the Wall
Street Journal.
Senate
Finance Committee Chair Max Baucus (D-Mont.) said he will
pursue several Medicare issues at a later date, including cuts to MA
plans and reversing a scheduled cut in physician reimbursement rates.
Baucus said he is considering cuts to MA plans that are "not as much" as
those in the House SCHIP bill, but he noted that some cuts "will be
significant."
A "major motivation" for lawmakers to reconsider
revisions to Medicare is the scheduled physician reimbursement rate cut.
Reducing payments to MA plans could help provide funds to delay the
physician reimbursement cuts, according to the Journal (Lueck, Wall
Street Journal, 9/19).
Details
A "number of fine points" within the compromise bill still "need to be
determined," according to a House Democratic aide (Wayne, CQ Today,
9/18). House Speaker Nancy Pelosi (D-Calif.) and
House
Energy and Commerce Committee Chair John Dingell (D-Mich.)
will ask Senate negotiators to accept small changes in the bill on
issues such as mental health, dental care, documented immigrant coverage
and pregnant women, according to
House
Ways and Means Committee Chair Charles Rangel (D-N.Y.)
(Johnson, CongressDaily, 9/18). House negotiators also are seeking
mental health parity under SCHIP (CongressDaily, 9/19).
Sen. Orrin Hatch (R-Utah) said he is willing to
hear Pelosi and Dingell's requests but is not willing to sacrifice any
votes that would cause them to lose a veto-proof margin in the Senate
(CongressDaily, 9/18). Rep. Deborah Pryce (R-Ohio) said that in the
House, "[m]ost of the moderates will vote for SCHIP if the Medicare
piece is taken out" (Weisman/Murray,
Washington Post, 9/19).
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Democrats to Revisit Medicare Provisions
By Sarah Lueck, Wall Street Journal
September 19, 2007 (WASHINGTON) - Cuts in Medicare
payments to private health insurers won't be included in a children's
health bill Democrats hope to send to President Bush next week, but a
top senator is vowing to return to the issue later in the year.
House Democrats, under heavy pressure to reach
final agreement with the Senate and send a bill to Mr. Bush before Sept.
30, when the children's health program is due to expire, have agreed to
drop Medicare-related provisions they approved in their chamber's
version of the bill.
But Sen. Max Baucus (D., Mont.), the
chairman of the Senate committee that oversees Medicare, said he will
pursue several Medicare issues later, including a payment increase for
physicians and cutbacks for insurers operating in Medicare Advantage...
Read the complete story at the Wall Street
Journal.
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Next Steps
Pelosi said that the House is expected to vote on SCHIP legislation
on Tuesday, CongressDaily reports. If the House passes the measure
unchanged, it will go directly to President Bush to sign or veto.
However, if the House makes changes to the bill, the Senate will
need to hold another vote -- which could give "GOP leaders a chance
to protest and cause delay," according to CongressDaily. Senate
Republican leaders have not decided whether they will block an SCHIP
bill if given the opportunity, according to a Senate leadership aide
(CongressDaily, 9/18).
Baucus on Tuesday said it is likely that the Senate will need to
re-vote on the legislation. If lawmakers are successful in passing
legislation by Sept. 30, when the program is set to expire,
Democrats will be able to blame the White House for allowing the
program to expire, House Majority Leader Steny Hoyer (D-Md.) said
(CongressDaily, 9/19).
Meanwhile, the administration has asked Congress to send the
president a short-term extension of the program. An
HHS
official said, "The proposals being discussed currently are unsound,
and it looks increasingly unlikely that this will get resolved by
Sept. 30.
Congress needs to pass a clean extension now so low-income
children will not lose their coverage and we will have sufficient
time to continue to work on this issue." Democrats have said they
will pass an extension of the program after the president issues a
veto (CongressDaily, 9/18).
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