House Panel Blocks Effort To Release Medicare Cost Estimates

The House Energy and Commerce Committee on Thursday voted 26-21, mostly along party lines, to report unfavorably a Democratic-sponsored resolution of inquiry that would have forced the Bush administration to release documents related to cost estimates for the new Medicare law, CQ HealthBeat reports (Carey, CQ HealthBeat, 9/30). According to White House Office of Management and Budget estimates released after Congress passed the Medicare law, the legislation will cost an estimated $534 billion over the next 10 years -- $134 billion more than previously estimated by the Congressional Budget Office. Medicare chief actuary Richard Foster has said the higher cost estimate was reached before the final House and Senate votes on the legislation in November, but former CMS Administrator Thomas Scully allegedly did not allow him to release the estimates.

Congressional Democrats have launched several investigations into the issue. In July, the HHS Office of Inspector General concluded in part that Scully "broke no law" when he ordered Foster to withhold the cost estimate. However, a legal opinion issued by the Government Accountability Office in September said that Scully should have to repay about half of his $145,600 salary for last year because of his actions.

The House Ways and Means Committee last week voted 19-12 to reject the same resolution, cosponsored by Reps. Charles Rangel (D-N.Y.) and John Dingell (D-Mich.). The resolution would force executive branch officials to release previously withheld cost information. Committee action on such a resolution is required within 14 legislative days of introduction (California Healthline, 9/24).

The resolution seeks "all documents, including telephone and electronic mail records, logs and calendars and records of internal discussions" related to the Medicare cost estimates (Rovner, CongressDaily, 9/30).

"This resolution is nothing more than 11th-hour politicking, a partisan effort to disparage the Medicare Modernization Act and the administration," Energy and Commerce Committee Chair Joe Barton (R-Texas) said (Johnson, CQ Today, 9/30). Barton added, "There is, after all, a presidential election in less than five weeks. And that's what this is all about: politics." However, Rep. Anna Eshoo (D-Calif.) said, "The issue is that pertinent information was withheld from this Congress. That should be pursued" (CQ HealthBeat, 9/30). Rep. Tom Allen (D-Maine) added, "Everybody knows that if this relevant information had been presented to the Congress (the Medicare bill) would not have passed" (CongressDaily, 9/30).

Dingell said, "Had President Clinton's administration tried to hide the ball like this, congressional subpoenas would have flown like confetti. But when the Bush administration hides the ball, all we get from the congressional majority is silence" (CQ Today, 9/30). Dingell added, "I won't say the administration lied, but it certainly didn't tell the truth" (CQ HealthBeat, 9/30).

Former CMS administrators Scully and Bruce Vladeck -- who headed the agency, then known as HCFA, from 1993 to 1997 as part of the Clinton administration -- on Wednesday debated the new Medicare law in Cleveland. Vladeck, now professor of health care policy and geriatrics at Mount Sinai School of Medicine, called the law a "paltry benefit" and "a turkey" that "will make millions worse off," while reaping a "windfall for the pharmaceutical and private health care industries." Vladeck said, "The increased cost of [beneficiaries'] prescriptions will over time exceed the value of any benefit for seniors."

Scully, now a health care lobbyist at the Washington, D.C., office of Alston & Bird, called Vladeck's remarks "silliness" and "a complete fabrication," adding that Democrats have opposed the law for political reasons and "the day after Election Day, they're going to love it." Scully said that the law "is a huge benefit for seniors," particularly for beneficiaries with low incomes (Jaffe, Cleveland Plain Dealer, 9/30).

NPR's "Morning Edition" on Friday included an interview with NPR's Andrea Seabrook about the ethics committee's admonishment of DeLay for alleged misconduct during the Medicare vote (Montagne, "Morning Edition," NPR, 10/1). The complete segment is available online in RealPlayer.

In addition, Doug Badger, a White House health care policy adviser, is scheduled to answer questions about Medicare on Friday at 2 p.m. ET in the "Ask the White House" chat. A transcript will be available online after the chat.