Federal Lawmakers Continue To Consider Medicare, Medicaid Spending Reductions
Several newspapers recently examined congressional efforts to reduce spending in the wake of Hurricane Katrina and in the midst of the fiscal year 2006 budget reconciliation process. Summaries of some of the pieces appear below.
CQ Today: With Democrats and moderate Republicans "balking at cutting Medicaid," Senate Finance Committee Chair Chuck Grassley (R-Iowa) is turning to Medicare to secure some of the cuts previously intended for Medicaid, CQ Today reports. Grassley is "wrestling with two major health care issues that have become intertwined: providing medical care to survivors of Hurricane Katrina and finding billions of dollars worth of budget-ordered spending cuts in the very program that would be expanded for the Katrina survivors," CQ Today reports. As part of the FY 2006 budget reconciliation process, the committee has been charged with finding $10 billion in Medicaid spending reductions over five years. Specifically, pressure to find spending reductions in Medicare has come from Sens. Gordon Smith (R-Ore.) and Olympia Snowe (R-Maine), who object to meeting the spending goal entirely through Medicaid. Republicans are considering Medicare cuts such as a $10 billion incentive fund for insurers created by the 2003 Medicare law; legislating a schedule for the phase-out of "budgetary neutrality" payments made to insurers who participate in the Medicare Advantage program, a process currently left to regulation; and Medicare's reimbursement rate for health insurers who offer coverage in rural areas. In addition, critics of the Medicare drug benefit have targeted it for cuts. CMS Administrator Mark McClellan said the Bush administration is "strongly committed" to current Medicare practices and added, "We've been able to set up a responsible and predictable approach to working with health plans in Medicare" (Wayne, CQ Today, 10/7).
New York Times: "[M]any liberal advocates wondered whether the floods [of Hurricane Katrina] offered a glimmer of opportunity" for their proposals on health care, the New York Times reports. However, "what looked like a chance to talk up new programs is fast becoming a scramble to save the old ones," according to the Times. Robert Greenstein, director of the Center on Budget and Policy Priorities, said, "We've gone from a situation in which we might have a long-overdue debate on deep poverty to the possibility, or perhaps even the likelihood, that low-income people will be asked to bear the costs." However, Stuart Butler, a vice president of the Heritage Foundation, said, "This is not the time to expand the programs that were failing anyway," adding, "The left has just talked up the old paradigm: 'Let's expand what's failed before'" (DeParle, New York Times, 10/11).
- Washington Post: Democratic leaders on Oct. 7 in a letter to Senate Majority Leader Bill Frist (R-Tenn.) said, "In our view, hurricane and energy price relief should be Congress's top priority." They added, "Rather than addressing the urgent needs of survivors and families and businesses suffering from rising gas prices, the Republican congressional leadership is pursuing reconciliation legislation that could only worsen their plight, with the cuts in Medicaid, food assistance and other benefits, and increase the deficit" (Weisman, Washington Post, 10/8).
The following newspapers also published articles related to the health care effects of the hurricane. Summaries appear below.
Los Angeles Times, "Shut Out on Health Care After Storm": The "still faltering" federal approach to provide health care for hurricane survivors offers no assistance to adults who have lost their jobs and health care benefits, the Times reports in a special series on hurricane recovery. As a result, the federal government "appears to punish those who had taken the most responsibility for their own care," according to the Times (Alonso-Zaldivar, Los Angeles Times, 10/9).
National Journal, "Katrina Spotlight on the Uninsured": National Journal on Saturday examined how issues related to Hurricane Katrina highlight a problem that "goes far beyond ... the immediate needs of the hurricane victims: the lack of health care coverage for the nation's working poor." According to National Journal, the increased cost of health insurance premiums and the "strong ideological differences" in Congress have "stymied federal action" to address the issue of the uninsured. Health care reform advocates hope that issues related to the hurricane will prompt a congressional debate over the issue of the uninsured, but lawmakers might not "go beyond providing temporary Medicaid help" to hurricane evacuees, National Journal reports. "What (Katrina) hopefully will do is shed a light on a strategy for people who are unlikely to get health insurance through the workplace. We need to look at a strategy that adds adults to coverage," Diane Rowland, executive director of the Kaiser Commission on Medicaid and the Uninsured, said. Grassley said, "A lot of people are bringing up Katrina to accomplish things they couldn't get done. I resent the interest groups riding on the tails of disaster to get things done. ... There's been a push by Democrats to bring up things they have not been able to bring up. It's wrong" (Werber Serafini, National Journal, 10/10).
USA Today, "Evacuee Benefits Differ by State": Medicaid eligibility for hurricane survivors differs from state to state, with "displaced families finding the government aid they receive - from health care to housing - depends on where they landed," USA Today reports. For example, people evacuated to Louisiana have easier Medicaid eligibility requirements for children than many other states, while eligibility rules for adult evacuees in Alabama, Louisiana, Mississippi and Texas are "tougher ... than the national average," according to USA Today. Since Aug. 29, eight states have received federal waivers to speed Medicaid eligibility based on evacuees' home-state rules (Wolf, USA Today, 10/10).
- USA Today, "Flooded-Out Doctors Find 'A Mess' But Bounce Back": An estimated 6,000 physicians from Louisiana and Mississippi were displaced by Hurricane Katrina, and "no one knows how many doctors will return," USA Today reports (Appleby, USA Today, 10/10).