MEDICARE: Clinton ‘Blasts’ Givebacks to Health Plans
President Clinton has "assailed" a Republican plan to return $26 billion to $28 billion in Medicare funding to providers and HMOs over five years, saying too much of the money is dedicated to Medicare managed care organizations, the Associated Press reports. In a letter to House Speaker Dennis Hastert (R-Ill.), Clinton "complained" that Republicans are willing to give between 40% and 55% of the giveback funds to insurers but have not supported patients' rights legislation that would make insurers "accountable" by giving patients the right to sue. "Unfortunately, it appears that instead of patient protections, legislation intended to restore reductions in the Medicare program is unduly tilted towards the HMOs who killed the patients' bill of rights," Clinton said (Associated Press, 10/11). Clinton administration officials also "doubted" that increased funding to HMOs would bring HMOs to enter or rejoin the Medicare program and that the effort is a "waste of money" (Pear, New York Times, 10/12). Negotiators from the House Ways and Means and Commerce committees and the Senate Finance Committee finished work on the giveback legislation ( HR 5291) yesterday, and had planned to attach it to the FY 2001 Labor-HHS appropriations bill, "theoretically as a 'sweetener' to encourage the president to sign the spending measure, notwithstanding continuing disputes over education spending and other issues," CongressDaily/A.M. reports. But Clinton's disapproval of the giveback measure has "left leaders looking for alternate vehicles to carry the Medicare package" -- possibly including a "popular" bill to permit states to provide Medicaid coverage for breast and cervical cancer treatment, which "overwhelmingly" passed the House last spring and the Senate last week. Backers of the cancer bill had been "expecting quick action in the House to clear it" and "cried foul" over the potential attachment of the giveback legislation. "There's no reason to play games with women's lives," Jennifer Katz of the National Breast Cancer Coalition said. Meanwhile, CongressDaily/A.M. reports that industry lobbying over the giveback bill "reached the press release stage" yesterday, as hospital and managed care representatives "insisted that the money was needed not for them but for the most vulnerable of Medicare beneficiaries" (Rovner, CongressDaily/A.M., 10/12). The New York Times reports that "furious battles" took place between health care lobbyists who all want increased Medicare funds. "With little hope of enlarging the pie, each sector of the health care industry sought a bigger slice for itself" (Pear, New York Times, 10/12).
Patients' Rights Resuscitation?
House and Senate leaders also "conceded" yesterday that Congress will not be able to complete its work by the week's end and are likely to bring before the House today a continuing resolution to extend the session another week (Earle, CongressDaily, 10/11). Rep. Charles Norwood (R-Ga.), "anxious not to see his efforts to pass a patients' bill of rights die for the second consecutive Congress," may try to attach the "newest version" of his managed care reform bill to that continuing resolution, CongressDaily/A.M. reports. If Norwood succeeds, the "high-stakes action" would "force ... an up or down vote" on the newest version of the Norwood-Dingell patients' rights legislation in the Senate, where an endorsement of the measure last week by Sen. John Ashcroft (R-Mo.) theoretically provides a 51-vote majority. At the same time, however, members of a House-Senate conference committee working to bridge differences between Norwood-Dingell and a more restrictive measure that passed the Senate this summer "say they have not given up either." One unnamed House conferee said Senate Republicans might still agree to allow patients some ability to sue health plans over benefit denials and to cover all members of private health insurance plans, rather than the more limited coverage scope of the Senate-passed version (Rovner, CongressDaily/A.M., 10/12).