Republican-Controlled Congress Likely To Shift Health Care Agenda
Republican lawmakers, who will assume control of both the House and Senate in the 108th Congress next year, will likely use their "substantially increased power" to "change the national debate" on health care and enact market-based reforms, the Wall Street Journal reports. For example, Republicans hope to pass a Medicare prescription drug benefit that "relies heavily" on private insurers, rather than the federal government, to provide coverage (Rogers et al., Wall Street Journal, 11/7). Sen. Charles Grassley (R-Iowa), who will likely assume the chair of the Senate Finance Committee, which has jurisdiction over Medicare legislation, said that his agenda next year will include a prescription drug benefit bill (Hulse, New York Times, 11/7). The prescription drug benefit legislation, which GOP lawmakers may propose as part of a larger Medicare reform bill, could focus on low-income beneficiaries rather than all Medicare beneficiaries, the Hartford Courant reports (MacDonald, Hartford Courant, 11/7). "Let's quit talking about doing something for the low-income elderly that need prescription drugs" and pass legislation to address the issue, Senate Minority Leader Trent Lott (R-Miss.), who will likely assume the position of Senate majority leader, said (Clymer, New York Times, 11/7). The pharmaceutical industry hopes that such legislation would "ward off pressure" to place caps on prescription drug prices (Rogers et al., Wall Street Journal, 11/7). The Pharmaceutical Research and Manufacturers of America donated more than $12 million to Republican candidates in the 2002 election cycle (California Healthline, 10/15). Pharmaceutical companies predict that their contributions to GOP candidates will place an industry-supported prescription drug benefit on the "fast track" to approval next year (Russell Chaddock, Christian Science Monitor, 11/7). The Republican-controlled Congress also may block legislation to increase access to generic treatments, a move that would benefit brand-name pharmaceutical companies (Wall Street Journal, 11/7). "You'll see policy that is friendly to the drug industry" in the 108th Congress, AARP Policy Director John Rother said (Hartford Courant, 11/7).
Republican lawmakers also hope to pass legislation to limit damage awards in medical malpractice lawsuits (Rogers et al., Wall Street Journal, 11/7). The House in September passed a bill that would limit the amount of noneconomic and punitive damages that juries could award in malpractice lawsuits, but the Senate has not passed similar legislation (AP/USA Today, 9/26). "A Republican-controlled Senate will be much more likely to deal with the issue," American Hospital Association Executive Vice President Richard Pollack said (Freudenheim, New York Times, 11/7). In addition, Sen. Judd Gregg (R-N.H.), who will likely assume the chair of the Senate Health, Education, Labor and Pensions Committee, plans to make "business-friendly changes" to the Family and Medical Leave Act, a 1993 law that requires employers to provide employees with as many as 12 weeks of unpaid leave for serious illnesses or to care for a newborn or a family member with an illness (Dreazen/Hitt, Wall Street Journal, 11/7). Managed care organizations also hope that the GOP-controlled Congress will pass legislation that mandates that states cannot require HMOs to provide certain services, such as podiatry and acupuncture. The New York Times reports that HMOs can "stop worrying" about patients' rights legislation that would allow members to file lawsuits to resolve disputes (Freudenheim, New York Times, 11/7). Several health insurance analysts predicted that the patients' rights "bill is dead" next year (Hartford Courant, 11/7). Hospitals and other providers hope that Republican lawmakers will pass a Medicare provider "giveback" bill with reductions in reimbursements scheduled to take effect on Jan. 1 (Freudenheim, New York Times, 11/7). In addition, health insurers, such as the Blue Cross Blue Shield Association, hope that GOP lawmakers next year will consider tax credits to help low-income employees and small businesses purchase health insurance (Hartford Courant, 11/7).
However, the "narrow margins" of GOP control in the Senate -- 51 Republicans, 47 Democrats, one Independent and one still undecided seat -- may limit the ability of Republicans to move their health care legislation through Congress (Rogers et al., Wall Street Journal, 11/7). For example, Norman Ornstein, an analyst at the American Enterprise Institute, said that a Republican-sponsored Medicare prescription drug benefit bill "will not be a slam dunk" in the Senate next year (Hartford Courant, 11/7). Senate Republicans will have to address the concerns of centrist senators to reach a compromise on the legislation, the New York Times reports (Clymer, New York Times, 11/7). In addition, increased federal budget deficits also may impact the "quest to put a Republican stamp on health care," the Journal reports. The government ended fiscal year 2002 with a $159 billion deficit, and the Congressional Budget Office estimates a $145 billion deficit for fiscal year 2003 -- which could prevent the passage of a prescription drug benefit (Rogers et al., Wall Street Journal, 11/7). Increased federal budget deficits also may prevent passage next year of legislation to help the uninsured (Hartford Courant, 11/7).
Meanwhile, President Bush hopes that Republican lawmakers will address a large part of his agenda, which includes a number of health care proposals, in a lame-duck session scheduled to begin on Nov. 12, the Washington Times reports (Sammon, Washington Times, 11/7). Republicans may assume control of the Senate in the lame-duck session based on whether Sen. Dean Barkley (I-Minn.) -- whom Minnesota Gov. Jesse Ventura (I) appointed to fill the Senate seat left vacant last month by the death of Sen. Paul Wellstone (D-Minn.) -- caucuses with Republicans and whether former Rep. Jim Talent (R-Mo.) -- who defeated incumbent Sen. Jean Carnahan (D-Mo.) in a special election and will take office after the election results are certified -- is "seated quickly" (Mitchell, New York Times, 11/7). Bush has asked Republican lawmakers to address patients' rights legislation, a ban on human cloning, an increase in funds for community health centers and other proposals (Washington Times, 11/7). Republican lawmakers also hope to address a Medicare prescription drug benefit and a ban on "partial-birth" abortion (Mitchell, New York Times, 11/7). In addition, they have said that they plan to address a Medicare provider "giveback" bill (California Healthline, 11/1). However, Lott said that he hopes to conclude the lame-duck session in a few days and delay most major legislation until next year (Mitchell, New York Times, 11/7).
In other news, Rep. Richard Gephardt (D-Mo.) today plans to announce that he will step down as minority leader, two days after Democrats "suffered historic losses" in the 2002 elections. Reps. Nancy Pelosi (D-Calif.) and Martin Frost (D-Texas) will become the likely candidates to replace Gephardt (Espo, AP/Washington Post, 11/6). Several Democratic senators said that Sen. Tom Daschle (D-S.D.) will likely retain his position as Democratic leader next year (Connolly, Washington Post, 11/7).
A roundup of multimedia coverage regarding the election's impact on the congressional agenda appears below:
- CNN's "Crossfire" featured Rep. Harold Ford (D-Tenn.), who addressed the election's potential impact on Medicaid and Medicare for underserved rural and urban areas (Begula et al., "Crossfire," CNN, 11/6). A transcript of the show is available online.
- NPR's "All Things Considered" featured Alan Greenblatt of Governing Magazine (Jaffe, "All Things Considered," NPR, 11/6). The full segment is available online in RealPlayer.
- NPR's "Talk of the Nation" featured Rep. Tom Reynolds (R-N.Y.), who said, "And as we now look at a Senate that has a Republican majority, my hope is that we will be able to get an agenda in the Senate that will be able to take up these measures ... like prescription drugs ... and begin to move these important pieces of legislation through the Senate, get them compromised between the House and Senate and send to the president," (Neary, "Talk of the Nation," NPR, 11/6). The full segment is available online in RealPlayer.
- PBS' "NewsHour with Jim Lehrer" featured Ornstein who said, "There's a major health agenda that we have out there. Remember that almost every Republican running for election pledged to do a prescription drug benefit; they want to do a very different one than the Democrats, but now they can put their item -- one that doesn't use Medicare for the prescription drug benefit but private insurers on the agenda, and we're going to have to deal with Medicaid, as well as perhaps insurance for everybody who doesn't have it" (Ifill, "NewsHour with Jim Lehrer," PBS, 11/6). A transcript of the "Election '02: Impact" segment is available online. In addition, the segment is available online in RealPlayer.