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Senior Citizen Politics
Medicare Advantage Pay Cuts, Physician Pay Raise in
SCHIP Bill by Democrats
Allows HHS Secretary to expand Medicare preventive
services
July 23, 2007 - House Democrats on Sunday announced
that they will unveil draft legislation within the next several days
that would increase SCHIP funding by $50 billion over five years and
make revisions to Medicare, the
New York Times
reports.
The House legislation, called the Children's Health
and Medicare Protection Act, would increase tobacco taxes and cut
Medicare payments to private Medicare Advantage plans to reauthorize and
expand SCHIP, according to the Times. The House bill also would reverse
a scheduled cut in Medicare payments to physicians and provide a modest
increase in fees for each of the next two years.
In addition, the legislation would:
● Simplify the Medicare application process and
relax the current asset limits;
● Allow the
HHS
secretary to expand Medicare coverage of preventive screenings;
● Pay primary care physicians to coordinate the
care of some traditional Medicare beneficiaries;
● Abolish a provision of the 2003 Medicare law
that mandates the president propose changes in Medicare to limit the
program's reliance on general revenue;
● Give state insurance commissioners more power
to regulate the marketing of private MA plans by agents and brokers; and
● Reduce payments to private MA plans, which are
estimated to be 12% higher than payments for the traditional program for
equivalent benefits (Pear, New York Times, 7/23).
However, House Democrats from rural states and
urban areas "have expressed concern that cuts to [MA] plans could hurt
members in their districts," according to
CQ HealthBeat.
In addition, other conservative Democrats are opposing a tobacco tax
increase at a similar level as legislation approved by the Senate
Finance Committee last week (Carey, CQ HealthBeat, 7/20).
The Senate bill would increase five-year funding
for SCHIP by $35 billion to $60 billion by raising the federal cigarette
tax from 39 cents to $1 per pack. President Bush has proposed a $5
billion increase over five years for SCHIP, which would increase the
program's total five-year funding to $30 billion. Bush has said that he
would veto the Senate bill (Kaiser
Daily Health Policy Report, 7/20).
The House bill "promises to intensify the battle
with the White House over health care," although House Democrats say
that by including changes to Medicare, "they have built a strong
intergenerational coalition that could help them overcome a presidential
veto," the Times reports. House Democrats said they expect to consider
the bill next week (New York Times, 7/23).
National Governors Association
In related news, the
National Governors
Association on Sunday passed a resolution urging Congress to
reauthorize SCHIP before it expires on Sept. 30, the
Detroit Free Press
reports (Gray, Detroit Free Press, 7/22).
In a letter sent to congressional leaders and Bush,
the governors called for the reauthorization of the program with a
guarantee that states be allowed flexibility in designing the program.
However, the governors did not endorse a specific funding level for the
reauthorization or "explicitly endorse" raising the cigarette tax to
fund SCHIP, according to the
Washington Post.
The governors wrote that "the authorization for
this critical safety net program will soon expire, and urgent action is
needed to ensure its continued success for the next five years."
The governors added, "For many reasons, defaulting
to a series of temporary extensions of the program would be untenable
for states and the millions of children who rely upon the program."
In addition, the governors wrote, "We are
encouraged by the Senate Finance Committee efforts to move a bipartisan
reauthorization bill that provides increased funding and reflects the
general philosophy that state flexibility and options and incentives for
the states are preferable to mandates."
The letter, which was drafted and approved at the
association's annual summer meeting, was signed by Govs. Janet
Napolitano (D-Ariz.), chair of NGA; Jon Corzine (D-N.J.), chair of the
association's
Health and Human
Services Committee; Tim Pawlenty (R-Minn.), vice chair of
NGA; and Jim Douglas (R-Vt.), vice chair of the committee (Broder,
Washington Post, 7/23).
Gov. Jim Douglas (R-Vt.) said, "It's important for
[governors] to speak with one voice," adding that the association does
not "have a consensus on the tobacco tax. We're just interested in
adequate funding and flexibility for the states" (Detroit Free Press,
7/22).
>> The letter is available
online.
Ad Campaign
Meanwhile,
AARP and
the
American Medical
Association on Monday will launch a $1.3 million advertising
campaign to lobby for the passage of the House and Senate versions of
SCHIP reauthorization and expansion legislation, CongressDaily reports.
The ads will air in the national media as well as
targeted districts for about two weeks and will feature direct mail and
meetings with lawmakers in their districts.
According to the ads, the House bill "preserves
access for Medicare patients and limits seniors' out-of-pocket costs,"
and "strengthens Medicare and ensures funds are used wisely, and extends
health care for millions of uninsured children."
The ad campaign also criticizes tobacco and health
insurance companies that oppose the bills. The ads states, "Powerful
special interests are making misleading claims about critical health
care reform facing America" (Leonatti, CongressDaily, 7/20).
Veto Override
Bush "could face a first in his presidency": a veto
override, if he vetoes SCHIP reauthorization legislation, the
Los Angeles Times
reports. According to the Times, there is a "good chance" that
Republicans would join Democrats to override a veto, in part because
Democrats could use Bush's veto to "tar GOP incumbents in next year's
elections" (Alonso-Zaldivar, Los Angeles Times, 7/22). Rep. Fred Upton
(R-Mich.) said that Bush's veto "will really force the two sides to get
together."
Sen. Gordon Smith (R-Ore.) said that many
Republicans are "very nervous," adding, "On the one hand, you've got the
veto threat. On the other hand is the political importance of expanding
health care for children. This is public policy broadly supported by the
American people" (Johnson, CongressDaily, 7/23).
Sen. Orrin Hatch (R-Utah) said that SCHIP
legislation "accomplishes what we have set out to do -- to take care of
the children" despite its costs (Struglinski,
Salt Lake City
Deseret Morning News, 7/20).
>> NPR's "All
Things Considered" on Saturday reported on the debate over
SCHIP reauthorization. The segment includes comments from Sen. Trent
Lott (R-Miss.), Senate Finance Committee Chair Max Baucus (D-Mont.),
Sen. Chuck Grassley (R-Iowa) and a cigar store owner (Rovner, "All
Things Considered," NPR, 7/21). Audio of the segment is available
online.
Opinion Piece, Editorial
● Sen. John Kerry (D-Mass.),
Boston Herald:
The Senate proposal of $35 billion over five years does "far too little"
to provide health insurance to children but is a "good start," Kerry
writes in a Herald opinion piece. Kerry writes that $50 billion over
five years would be a "better option." He continues, "America stands
behind our children, and Democrats in Congress should not bend to
pressure from the White House, Republicans or special interests" (Kerry,
Boston Herald, 7/23).
●
New York Times:
Bush has threatened to veto SCHIP "on the bizarre theory that expanding
it would be the 'beginning salvo' in establishing a government-run
health care system," according to a Times editorial. If more revenue is
needed to fund SCHIP, the House "should consider a new tax on alcohol,
which would also have health benefits, or a reduction in the large
subsidies paid to private health plans to participate in Medicare," the
editorial continues. It concludes, "The important thing is to cover as
many uninsured children as politically feasible and hang the ideological
warfare" (New York Times, 7/22).
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