CQ's Carey Discusses SCHIP, Labor-HHS-Education Bill, Medicare Physician Fee Cut

Main Category: Medicare / Medicaid / SCHIP
Also Included In: Primary Care / General Practice
Article Date: 20 Nov 2007 - 7:00 PDT

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Mary Agnes Carey, associate editor of CQ HealthBeat, examines SCHIP negotiations, the Labor-HHS-Education spending bill veto and efforts to delay a scheduled Medicare physician fee cut in this week's "Health on the Hill from kaisernetwork.org and CQ."

Democratic leaders and House Republicans were unable to reach a compromise before the Thanksgiving recess on legislation that would reauthorize and expand SCHIP, Carey says. Some Republicans want the bill to include stricter measures to prevent undocumented immigrants from enrolling in the program, as well as language that would cap Medicaid eligibility at 300% of the federal poverty level and prohibit states from excluding certain types of expenses when determining SCHIP or Medicaid eligibility. However, if the legislation makes too many concessions to Republicans, it could lose the support of Democratic lawmakers, Carey says. A temporary funding extension for SCHIP ends Dec. 14. Negotiations are expected to continue when Congress reconvenes, and lawmakers could pass a longer-term extension of the program.

Carey also discusses House lawmakers' failure to override President Bush's veto of the Labor-HHS-Education appropriations bill. Bush vetoed the legislation -- which includes spending for Medicare, Medicaid and NIH, among other health-related programs -- because he said it was excessive. The measure included $9.7 billion in discretionary spending above the president's request. According to Senate Majority Leader Harry Reid (D-Nev.), House and Senate Democrats are considering sending Bush a multi-bill "omnibus" appropriations package next month, but a White House spokesperson said Bush has been clear about Congress passing individual appropriations bills at "reasonable and responsible" spending levels, Carey says.

Finally, Carey discusses efforts to stop a 10% Medicare physician fee cut scheduled for Jan. 1, 2008. According to Carey, the Senate Finance Committee likely will mark up a Medicare package early next month, and the package is "widely expected" to stop the scheduled fee cuts for one or two years. The physician payment fix likely would be financed by payment cuts to other Medicare providers, such as Medicare Advantage plans. Carey says that there might not be enough time left this year to move a stand-alone Medicare bill, so the fee fix could be combined with other legislation, such as a temporary extension of funding for SCHIP, or it could be part of an end-of-the-year omnibus package (Carey, "Health on the Hill from kaisernetwork.org and CQ," 11/19).

The complete audio version of "Health on the Hill," transcript and resources for further research are available online at kaisernetwork.org.

Reprinted with kind permission from http://www.kaisernetwork.org. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at http://www.kaisernetwork.org/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork.org, a free service of The Henry J. Kaiser Family Foundation© 2005 Advisory Board Company and Kaiser Family Foundation. All rights reserved.