Republicans Set To Discuss Budget Reconciliation Legislation
Republican congressional leaders have set "ambitious goals" of reaching agreement on a budget deficit reduction package and reviving the Labor-HHS spending bill that the House rejected last month, the Wall Street Journal reports. The budget package faces a "stee[p] uphill fight," and it challenges the Bush administration by proposing cuts to both Medicare and Medicaid, according to the Journal. A preliminary estimate of proposed cuts circulated on Tuesday show about $7 billion in cuts to Medicare over five years and $6 billion in cuts to Medicaid over five years.
The Journal reports that, while the cuts are considered "modest," the Bush administration indicated that it still opposes reductions in Medicare spending.
House Speaker Dennis Hastert (R-Ill.) said that the White House has "seen how this legislative process works," adding, "They have to give us something to work with" (Rogers, Wall Street Journal, 12/7).
House Energy and Commerce Committee Chair Joe Barton (R-Texas), the lead House negotiator on Medicaid, said talks have been "cordial." However, Barton said the House and Senate are at a "stalemate" because "[t]he Senate won't take anything that doesn't have something in it on [the Arctic National Wildlife Refuge], and the House won't take anything with it" (Cohn, CongressDaily, 12/7).
At the same time, the House on Wednesday will appoint negotiators to work with the Senate on proposed revisions to the Labor-HHS appropriations bill. According to the Journal, some Republicans believe that by shifting $125 million in funding to rural health and education, the bill will win passage (Wall Street Journal, 12/7).
In related news, provisions in the Senate version of the reconciliation bill (S 1932) that would adjust doctors' Medicare payments based on how often they use the most efficient medical procedures are drawing opposition from the medical device industry and a coalition of patient organizations, CQ HealthBeat reports.
The bill would adjust Medicare physician payments based on how often a doctor uses a medical procedure ranked against the number of times other physicians used the procedure, according to CQ HealthBeat. The language in the bill was "lifted almost verbatim" from a bill (S 1356) by Senate Finance Committee Chair Chuck Grassley (R-Iowa) and ranking member Max Baucus (D-Mont.).
Steve Ubl, president of AdvaMed, said the provisions would give the HHS secretary "unlimited authority to establish a system that penalizes providers who generate more spending than average and rewards those who cut costs, irrespective of quality."
The device industry wants the Senate language rewritten so that it "would prevent doctors from stinting on care and from clinging to cheaper, second-rate technology in order to qualify for the efficiency payments," CQ HealthBeat reports.
Marcie Roth, executive director of the National Spinal Cord Organization, in a press release also issued by 17 other patient groups said, "When doctors are given disincentives from treating people with the most significant health care needs, that not only affects the individual but the whole system."
Aides to Grassley and Baucus could not be reached for comment (CQ HealthBeat, 12/6).