107th Congress’ Health Care Agenda for Lame-Duck Session ‘Unclear’
Lawmakers hope to pass homeland security and appropriations bills in a lame-duck congressional session scheduled to begin today, but whether they will address other issues, such as a Medicare provider "giveback" bill, remains "unclear," CongressDaily/AM reports (Ghent et al., CongressDaily/AM, 11/12). Democrats will control the Senate when the session begins. Interim Sen. Dean Barkley (I-Minn.) -- whom Minnesota Gov. Jesse Ventura (I) appointed to fill the Senate seat left vacant last month by the death of Sen. Paul Wellstone (D-Minn.) -- said yesterday that he will not caucus with Republicans or Democrats, which allows the Democrats the retain control of the Senate. However, control of the Senate will shift to Republicans when Sen.-elect Jim Talent (R-Mo.) -- who defeated Sen. Jean Carnahan (D-Mo.) in a special election and will take office after the election results are certified -- is seated (Dewar, Washington Post, 11/12). The expected shift in Senate control in the lame-duck session has raised questions about whether Congress will resolve the fiscal year 2003 budget process. Although President Bush and House Speaker Dennis Hastert (R-Ill.) have said that they hope to complete the process before the next Congress, Senate Minority Leader Trent Lott (R-Miss.), who will likely become Senate majority leader when control of the chamber shifts to Republicans, said that he would prefer to pass continuing resolutions to avoid "protracted debate" over appropriations bills. The use of continuing resolutions in the lame-duck session also would "side-step" the expected debate in the Senate when control shifts to Republicans. However, in the event that Congress extends the lame-duck session to pass a homeland security bill, which could affect several federal health agencies, lawmakers also would have time to address appropriations bills, CongressDaily/AM reports.
Congress will not likely address a Medicare provider giveback bill in the lame-duck session, although the issue received "much attention" before the Nov. 5 election, CongressDaily/AM reports (Fulton, CongressDaily/AM, 11/12). In June, the House passed a $30 billion Medicare bill that included provider giveback provisions and a prescription drug benefit, but the Senate has failed to approve similar legislation (California Healthline, 10/2). HHS has delayed the next scheduled round of Medicare provider payment reductions until December to allow lawmakers time to reach an agreement on provider givebacks, but congressional aides and lobbyists said that Congress will not likely address the issue "head-on." Lobbyists said that Republicans may consider a provider giveback bill as a vehicle in the next Congress for other health care issues, such as a Medicare prescription drug benefit, tax credits for the uninsured and association health plans. "Why would we want to do a bill today when we can come back and do it with a Republican majority?" a Republican aide said. Some lobbyists said that Congress may attach the legislation to a continuing resolution that would prevent reductions in Medicare reimbursements for physicians or allow HHS to establish the rates, a move that could take the "immediate pressure off" of lawmakers and prevent other providers, such as hospitals, nursing homes and HMOs, from "piling on" (Fulton, CongressDaily/AM, 11/12). CMS Administrator Tom Scully said that the Bush administration does not have the authority to establish Medicare reimbursement rates for physicians and that scheduled reimbursement reductions could prompt "angry doctors" not to treat Medicare beneficiaries. In addition, he said that the "real problem" is that Congress cannot "say 'yes' to doctors and 'no' to every other health provider group with its hand out" (Rovner, "Morning Edition," NPR, 11/12). The full "Morning Edition" segment will be available after noon ET online. In addition, extended NPR coverage is available online.
Prospects for passage of a bill supported by President Bush that would establish a Department of Homeland Security "appear to have improved" (Washington Post, 11/12). Under the legislation, which the House passed earlier this year, the department would include parts of 22 federal entities. The CDC would play an important role in the department; the bill would expand and modernize the agency's Epidemic Intelligence Service to improve the nation's response to a bioterrorist attack. The bill has stalled in the Senate because some Democrats maintain that the legislation would reduce civil service protections and other rights for employees of the department (California Healthline, 11/8). Negotiations over the weekend led to a staff-level agreement on the legislation, but "key" lawmakers must accept the compromise (Ghent et al., CongressDaily/AM, 11/12). Lott said that he hopes the bill passes the Senate this year "by a wide margin" (Washington Post, 11/12). Meanwhile, prospects for legislation to expand access to generic treatments that passed the Senate earlier this year but has since stalled in the House are "not good" in the lame-duck session, the San Francisco Chronicle reports (Abate, San Francisco Chronicle, 11/11).This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.