Medicare Provider ‘Giveback’ Bill Unaffordable, Office of Management and Budget Head Says
White House Office of Management and Budget Director Mitch Daniels yesterday told Republican lawmakers that the federal government cannot afford to pass a Medicare provider "giveback" bill because of decreased revenues, the Detroit Free Press reports (Detroit Free Press, 10/10). The House in June passed a $30 billion Medicare reform bill that includes provisions to increase reimbursements for providers, but the Senate has not reached agreement on a 10-year, $43 billion bill sponsored by Sens. Max Baucus (D-Mont.) and Charles Grassley (R-Iowa). The Senate bill includes smaller than planned reimbursement reductions for hospitals and increases for rural physicians, hospitals and home health care agencies. Medicare+Choice plans would receive a 4% reimbursement increase in 2003 and 3% increase in 2004 under the legislation. The bill also would reverse the expiration of $1.7 billion in temporary Medicare reimbursements for nursing homes that ended Oct. 1. In addition, the legislation would expand a pilot program that uses competitive bidding for durable medical equipment nationwide. The bill also includes a provision that would allow Medicare to cover immunosuppressive treatments for organ transplants and would renew a five-year program that helps low-income seniors cover the cost of Medicare premiums. The legislation includes a two-year delay of reimbursement caps for physical and occupational therapy and would expand coverage of cholesterol and lipid level tests. The bill also includes additional funds for state Medicaid and CHIP programs (California Healthline, 10/9).
According to Daniels, the federal government cannot afford to increase Medicare reimbursements for providers. "I think that any rationale for $30 billion, $40 billion the nation cannot afford to be sent off to health care, just because we always do it, is unthinkable," Daniels said. He added, however, that the Bush administration would consider a Medicare provider giveback bill "if lawmakers are able to find cuts to offset the increases." Meanwhile, AARP officials said that the Senate should not increase reimbursements for Medicare providers before they add a prescription drug benefit to the program. "Less than 10% of that package would directly benefit Medicare beneficiaries -- the people the program is supposed to be serving," AARP CEO William Novelli wrote in a letter to Senate leaders (Carter, Associated Press, 10/9).
In related news, the Hartford Courant today examines the congressional record on health care issues this year and reports that lawmakers "will bat zero-for-three" on the health-related issues that have received the most attention since the 2000 election -- patients' rights legislation, a Medicare prescription drug benefit and generic drug legislation. Robert Moffitt, a health policy analyst at the Heritage Foundation, said that "deep philosophical difference[s]" between Republicans and Democrats over the role government plays in health care and the small majorities that Republicans have in the House and Democrats have in the Senate have stalled health care legislation this year. Although the House passed a bill earlier this year that includes a Medicare prescription drug benefit, the Senate has failed to pass similar legislation; the Senate earlier this year passed a generic drug bill, but the House does not plan to address the issue. In addition, negotiations to resolve differences in patients' rights bills passed last year in the House and Senate have failed. Bruce Freed, a Capitol Hill analyst, attributed the failure to pass generic drug legislation and a Medicare prescription drug benefit bill in part to pharmaceutical industry campaign contributions to Republicans. He also questioned whether Democrats "lost interest" in patients' rights legislation over concerns that President Bush would "seize credit" for the bill (MacDonald, Hartford Courant, 10/10).This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.