Tax Bill Passage Unlikely, Providers Plead for Medicare Givebacks
Senate Republican leaders yesterday "ruled out passage" of the $240 billion tax relief package (H.R. 4577) that includes the $30 billion Medicare givebacks provision (H.R. 5543), saying that lawmakers should wait to decide fiscal matters "until a new administration takes control," the Washington Post reports. However, Republicans and Democrats seem to have reached a "bipartisan consensus" to separate the Medicare and Medicaid "giveback" measures from the tax bill so that providers will not have to wait for relief. The death of the tax bill is "aimed at leaving [Texas Gov. George W.] Bush maximum leeway in using future surpluses for tax breaks and new spending" (Pianin/Morgan, Washington Post, 12/7). Senate Majority Whip Don Nickles (R-Okla.) "said it would be better to pass what [Republicans] regard as a better bill should" Bush become president, CongressDaily/A.M. reports. The bill also faced a potential filibuster by Sen. Ron Wyden (D-Ore.), who objects to the possible inclusion of the Pain Relief Promotion Act (H.R. 5544), a measure intended to repeal Oregon's assisted suicide law (Norton, CongressDaily/A.M., 12/7).
Providers yesterday called on Capitol Hill to make a "final plea" for relief from the "deeper-than-intended" 1997 Balanced Budget Act cuts. "Hospitals are in financial crisis and they desperately need your help," Charles Barnett of the Texas-based Seton Health Care Network told a forum sponsored by Sens. Ted Kennedy (D-Mass.) and Kay Bailey Hutchison (R-Texas). Lynn Collins O'Connor of the Washington Home in Washington, D.C., added that nursing homes have fallen into "similar straits." She said, "What Congress does or doesn't do in this special session will have a severe impact on the nation's ability to maintain our skilled nursing services." The nine senators -- five Republicans and four Democrats -- who attended the session appeared "sympathetic" to the providers' plight. "Even if we have to stay here until New Year's Eve, Congress cannot leave until it fixes the enormous hardships now being imposed on hospitals and health care providers across our country," Sen. Paul Wellstone (D-Minn.) said.
However, GOP leaders have not yet "signaled their agreement" to additions to the givebacks provision that would appease President Clinton and congressional Democrats. Clinton has "complained" that the bill provides too large a proportion of funding to Medicare HMOs, and too little to "insurance coverage improvements." In addition, Democrats have demanded increases of about $4.5 billion over five years for Medicaid, including provisions to ease the enrollment restrictions for children in Medicaid and CHIP, and a bipartisan bill -- the "Family Opportunity Act" -- that would allow families with severely disabled children to purchase Medicaid coverage.
The bill's chief sponsor, Sen. Charles Grassley (R-Iowa) has reportedly urged Senate Majority Leader Trent Lott (R-Miss.) to accept a "scaled-down" version of the family opportunity bill. During the forum Tuesday, Steve Berman of the American Academy of Pediatrics also implored Congress to pass the bill this year. "No family of a child with severe disabilities should have to choose between poverty and health care services for that child," he said. Meanwhile, the Center on Budget and Policy Priorities released a study estimating that 95% of low-income children meet Medicaid or CHIP eligibility requirements. The report also found that several provisions included in the bipartisan Medicare and Medicaid "giveback" legislation approved by the Senate Finance Committee earlier this fall could cover "large numbers" of children at a "relatively low cost." Some Republicans, however, continue to "resist" efforts to reopen the bill. According to Sen. Phil Gramm (R-Texas), if Clinton and the Democrats hope to pass a Medicare package, "They're going to basically have to take the bill that we've got" (Rovner,CongressDaily/A.M.).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.