Lawmakers Call for ‘Equal Footing’ Between Medicare+Choice, FFS
Calling the current "pricing structure" of Medicare+Choice an "abysmal failure," the House Ways and Means Committee's "two top health leaders" said last week that they will introduce legislation this fall to "immediately move" the program to a "level playing field with the [Medicare] fee-for-service plan," CongressDaily/AM reports. In a letter to Centers for Medicare and Medicaid (formerly HCFA) Administrator Thomas Scully, Ways and Means Chair Bill Thomas (R-Calif.) and Health Subcommittee Chair Nancy Johnson (R-Conn.) said that their proposal would, by 2004, shift Medicare+Choice to a "competitive system in which plans would be paid what they bid." The letter came one day after Scully said that Congress "should consider reallocating the payments for Medicare+Choice" established by the 1997 Balanced Budget Act, which "boosted payments in rural and traditionally low-cost areas and held-down increases in urban and higher-cost counties." But the BBA-passed increased reimbursements failed to entice plans to stay in many markets (Rovner, CongressDaily/AM, 9/5). Scores of health plans have dropped out of Medicare+Choice, and the Bush administration announced last week that "several hundred thousand" Medicare+Choice beneficiaries will see their health plans drop coverage for next year (California Healthline, 9/4). Scully said, "The issue is not spending more money. The issue is allocating money to areas where it can be used." But CongressDaily/AM reports that both the politics and finances of shifting payments from rural area to urban areas are "tricky." Budget analysts said that shifting funds into urban areas where they are more likely to be used would cost the program more (CongressDaily/AM, 9/5).
Meanwhile, the Senate Finance Committee, which had an "ugly parting" over a Medicare reform and a prescription drug bill before the August recess, has returned "with no apparent truce in sight," CongressDaily reports. On one side is a group of moderates, including Charles Grassley (R-Iowa), Olympia Snowe (R-Maine), Orrin Hatch (R-Utah), John Breaux (D-La.) and Jim Jeffords (I-Vt.), who introduced a proposal before the recess calling for broad-scale Medicare reform along with the addition of a drug benefit. On the other is Sen. Max Baucus (D-Mont.), chair of the committee, who along with Sens. Jay Rockefeller (D-W.Va.) and Bob Graham (D-Fla.), said that moderates' plan did not spend enough of the $300 billion set aside by Congress for Medicare reform on a drug benefit in its FY 2002 budget proposal. Calling the moderates' proposal "robbery, not reform," Baucus said he will not bring it for a committee vote. Nevertheless, the Bush administration is "keeping up the pressure" on Congress to pass a Medicare reform bill (Rovner/Fulton, CongressDaily, 9/4).
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