Grassley Withdraws Staff From Medicare Reconciliation Negotiations

Staff members for Senate Finance Committee Chair Charles Grassley (R-Iowa) last week withdrew from negotiations to resolve differences in the House and Senate Medicare bills (HR 1 and S 1), the New York Times reports (Pear, New York Times, 8/27). Grassley said that he withdrew his staff because he wants negotiators to begin talks on provisions in both bills that would allocate at least $25 billion to increase reimbursements to rural Medicare providers. He said that aides to House Ways and Means Committee Chair Bill Thomas (R-Calif.), who as head of the conference committee sets the conference committee's agenda, told Senate staffers they are not permitted to discuss such payments (Norman, Des Moines Register, 8/27). Earlier this year, the Senate approved a provision that would raise Medicare payments to rural providers by $25 billion. The House passed a similar provision. Grassley has indicated that he believes Thomas is stalling on such provisions as a way to gain leverage in the Medicare negotiations (Rogers, Wall Street Journal, 8/26). According to the Register, Grassley said that because the rural provider payment provisions were approved with "wide support" in both chambers and because both provisions are similar, he believes the issue is "noncontroversial" and one on which staffers should be able to quickly compromise. "There may be a billion dollars and a little bit of policy, but if you put them side by side there would be little difference between the two [provisions]," he said (Des Moines Register, 8/27).

Christin Tinsworth, a spokesperson for Thomas, said that Thomas favors additional assistance for rural providers but has a "more global view" of the legislation. He added that Grassley's staff "was not at the table" over the last two days to discuss the issue. A Thomas aide said, "Sen. Grassley did not even call Mr. Thomas to seek a remedy to his rural concern before he pulled his staff. There was no effort on Grassley's part to resolve the issue before his staff walked out." A Senate Republican leadership aide said, "This is a decision that Sen. Grassley made on his own. He and Mr. Thomas both have legitimate concerns. We hope this proves to be a bump in the road" (New York Times, 8/27). Grassley said that pulling his staff out of negotiations will not affect efforts to pass a final Medicare bill, the Register reports (Des Moines Register, 8/27).