President Bush Urges Medicare Conferees To Reach Compromise

In a meeting Thursday at the White House, President Bush urged members of the conference committee charged with reconciling the House and Senate Medicare bills (HR 1 and S 1) to work together to reach a compromise, but he did not make specific recommendations on how to find agreement on contentious issues, the Washington Times reports. Conferee Sen. Charles Grassley (R-Iowa) said, "[Bush] left the specifics to the Congress. He was talking more in terms of ... the political reality of getting something done and people cooperating" (Fagan, Washington Times, 9/26). CongressDaily/AM reports that Bush is pleased that conferees had agreed to a timeline for negotiations that would have them finish a final Medicare bill by Oct. 17 (Koffler/Rovner, CongressDaily/AM, 9/26). According to the Washington Times, Bush told negotiators that a drug benefit "must be available to all Medicare beneficiaries" and that private health plans should play a role in providing drug coverage (Washington Times, 9/26). He also told conferees that he is committed to completing a final bill, and he promised to be actively involved in the negotiations (CongressDaily/AM, 9/26). After the meeting, Bush said, "Today we ... had a good and frank discussion about the need to work together to get a Medicare bill that modernizes the system, that fulfills the promises to America's seniors" (Washington Times, 9/26). He said, "In my judgment, the sentiment was optimistic. I believe people know it's possible to get it done." He also said that he is committed to spending $400 billion over 10 years on Medicare reform, despite a growing federal deficit, the Wall Street Journal reports (Rogers/Lueck, Wall Street Journal, 9/26).

The Bush administration has begun encouraging Medicare negotiators to include financial incentives to ensure that preferred provider organizations participate in Medicare, the Washington Post reports. Bush's top health advisers have asked conferees to include in a final bill a provision that would create an "unspecified pool of money" that the HHS secretary could use to boost payments to PPOs that accept Medicare beneficiaries in certain parts of the nation, the Post reports. In addition, Bush administration officials have asked negotiators to include provisions that would ensure that rural hospitals providing care to Medicare beneficiaries enrolled in a PPO would be paid at least as much as those treating beneficiaries in traditional Medicare. A senior administration official said, "We believe the private plans are going to deliver better benefits and more options to seniors. We are looking to make sure in the final product the government is a good business partner." However, the Post reports that the proposals could indicate that the administration feels that neither the House nor Senate bill would attract enough participation by PPOs. The "late arrival" of the two proposals "irked" some members of the conference committee, the Post reports. "[W]e've got so many things to sort out" without the new administration proposals, a GOP House aide said (Goldstein, Washington Post, 9/26).

Many lawmakers have accused Bush of being "aloof" in the Medicare negotiations, the New York Times reports (Pear, New York Times, 9/26). According to the Los Angeles Times, Bush's "distant stance" in the Medicare negotiations could indicate his strategy is to "clai[m] victory on what seems legislatively possible and cu[t] his losses elsewhere." Sen. Max Baucus (D-Mont.) said, "The president's level of intensity [on Medicare negotiations] has to be greater" (Chen/Kemper, Los Angeles Times, 9/26). But Grassley said, "There were many rumors floating around town that the president was not very concerned about this issue. Our meeting today puts that sort of rumor to rest. ... The president not only wants this legislation; he's willing to expend the political capital to get it done" (New York Times, 9/26). Senate Majority Leader Bill Frist (R-Tenn.) said he is confident of Bush's "commitment to see this bill through," but he acknowledged that Bush had "made it clear that [the Medicare bill] is the responsibility of the United States Congress" (Los Angeles Times, 9/26). CongressDaily/AM reports that it is "unclear" how far Bush will go in his effort to participate in negotiations. After Thursday's meeting, HHS Secretary Tommy Thompson said that the president will not send any administration officials ranking higher than HHS secretary to Medicare negotiations. According to CongressDaily/AM, there has been speculation that sending Vice President Dick Cheney or some other high-ranking administration official to a negotiation session would "send a strong message" that Bush is focused on achieving a final Medicare bill (CongressDaily/AM, 9/26). CNN's "Live From the Headlines" Thursday reported on Bush's meeting with Medicare negotiators (Phillips, "Live from the Headlines," CNN, 9/25). A transcript is available online.

It still is unclear whether a final Medicare bill will more closely resemble the House-passed legislation or the Senate-approved measure, the Washington Times reports. According to some House conservatives, Bush's emphasis on bipartisan cooperation could mean that the final bill would look less like the House-approved measure. Many House Republican members are pushing for cost controls, a House-approved provision that calls for competition among private health plans and traditional Medicare beginning in 2010 and means testing for the drug benefit (Washington Times, 9/26). There also are some "fears" that House Ways and Means Committee Chair Bill Thomas (R-Calif.), head of the conference committee, will advocate a final bill that resembles the House version, "daring Democrats in the Senate to vote against it or be labeled obstructionists," CongressDaily/AM reports (CongressDaily/AM, 9/26). The Senate is not likely to approve a "conservative-leaning bill," the Washington Times reports (Washington Times, 9/26).

The Alliance to Improve Medicare, a coalition of health industry groups, on Friday is scheduled to launch a $3 million to $5 million print and television advertising campaign to urge lawmakers to overhaul Medicare, CongressDaily/AM reports. The print ad -- whose headline reads "Don't Come Home Without It" and depicts a senior reading a newspaper with the headline, "Seniors Wait for Rx Coverage" -- will run in Friday's Washington, D.C., regional edition of USA Today. Meanwhile, a similar television advertisement will run in the Washington, D.C., area during the Sunday talk shows. An AIM spokesperson said the campaign eventually will reach 15 states, including Arkansas, Georgia, Indiana, Louisiana, Nebraska and New Mexico. "We're targeting folks in the House and Senate most important to getting [a Medicare] bill done," the spokesperson said (CongressDaily/AM, 9/26).