Senate Republicans Under Pressure From American Medical Association To Pass Legislation That Would Stop Medicare Physician Fee Cut

Main Category: Medicare / Medicaid / SCHIP
Also Included In: Primary Care / General Practice
Article Date: 08 Jul 2008 - 11:00 PDT

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The office of Senate Majority Leader Harry Reid (D-Nev.) said that the Senate on Tuesday or Wednesday will hold another cloture vote on a House-passed bill (HR 6331) that would avert a 10.6% reduction to Medicare physician fees that was scheduled to take effect last week, Roll Call reports (Pierce, Roll Call, 7/7). Before the Fourth of July recess, the measure failed by one vote to receive the 60 votes required to gain cloture. The House last month passed the measure by a veto-proof margin. The bill is similar to a measure (S 3101) proposed by Senate Finance Committee Chair Max Baucus (D-Mont.), which also failed to receive enough votes for cloture (Kaiser Daily Health Policy Report, 7/2). If Congress does not pass legislation or an extension, the cut will go into effect next week.

The American Medical Association said that if the cut occurs, many physicians will stop taking Medicare beneficiaries (Roll Call, 7/7). Although both Democrats and Republicans want to avoid the cut, they cannot agree on how to pay for the measure, which would cost $20 billion over five years, the Wall Street Journal reports (Wilde Mathews, Wall Street Journal, 7/7). Democrats want to trim Medicare Advantage payments to finance the bill, while the White House and many Republicans oppose such cuts, CQ Today reports (Wayne, CQ Today, 7/3).

Democrats Hope for Change in Vote
Democrats believe that it is "very possible" that an advertising campaign aired last week by AMA put enough pressure on some Republicans to change their votes, Rodell Mollineau, a spokesperson for Reid, said. The ads aired on television and radio in Pennsylvania, New Hampshire, Texas, Mississippi, Tennessee and Wyoming. AMA President Nancy Nielsen said, "Physicians are very energized, and we've been getting calls from uncomfortable senators," adding, "The real proof in the pudding will not be how many calls we get or how uncomfortable senators are, but what the votes are" (Roll Call, 7/7).

Sen. Dick Durbin (D-Ill.) on Saturday in a national radio address called on Republicans to vote for the measure. He said, "It's time for the Republican senators who are filibustering this measure to put our seniors and our military families ahead of private insurance companies and let the Senate pass this bill as soon as possible" (Hirschfeld Davis, AP/Kansas City Star, 7/5). In addition, military families have joined AARP in lobbying for the bill, the New York Times reports (Pear, New York Times, 7/7).

America's Health Insurance Plans also ran its own ads opposing using cuts to the MA program as an offset. AHIP President and CEO Karen Ignagni said, "Nearly every Medicare Advantage beneficiary would be impacted" by the cuts to the program (Twedt, Pittsburgh Post-Gazette, 7/5). Republican Senate aides said that the vote total likely would not change from the previous vote (Roll Call, 7/7). Because "President Bush has vowed to veto the bill," the "fight -- and the uncertainty -- could continue for weeks," the Times reports (New York Times, 7/7).

Republicans Seek 31-Day Extension
Senate Minority Leader Mitch McConnell (R-Ky.), Minority Whip Jon Kyl (R-Ariz.) and Finance Committee ranking member Chuck Grassley (R-Iowa) on Thursday in a letter to Reid said that the Senate should pass a 31-day extension of physicians' current Medicare fees. The Republicans said that passing the House measure would be futile because Bush would veto it, and instead, the Senate should focus on a fix that Bush will sign (Roll Call, 7/7). AMA opposes a monthlong delay.

An extension would allow the Senate to again focus on compromise legislation that Baucus and Grassley were nearly finished with when the Medicare bill passed the House by a veto-proof margin, which sent the compromise measure to the back burner. Grassley said, "I've told [doctors] to tell their lobbyists in Washington that there's a bill the president will sign, and that's the Baucus-Grassley (bill), and to ask them, why are they backing a bill that the president will veto" (CQ Today, 7/3).

Opinion
Two newspapers published an editorial and a letter to the editor related to the Medicare legislation. Summaries appear below.

• New York Times: The Medicare bill "would largely and sensibly offset the additional costs" of stopping the fee cut "by reducing payments to private plans that participate in Medicare," the Times writes in an editorial. The Times continues, "The likely result would be slower growth for the private fee-for-service plans, which are the most heavily subsidized and least efficient Medicare plans," adding, "That is an outcome to be welcomed, not deplored." The editorial concludes, "Every American represented by one of the recalcitrant Republican senators should press them to change their votes" on the Medicare bill (New York Times, 7/5).
  
  
• Mary Newman, Baltimore Sun: The fee cut "will translate into a 20% to 30% pay cut after" internal medical physicians' "expenses are taken into account," Newman, governor of the Maryland chapter of the American College of Physicians, writes in a Sun letter to the editor. If that happens, "patients will lose access to physicians, timely appointments, preventive services and time with their doctors," Newman continues. Newman concludes, "Now we need the help of our patients to make sure that Congress acts quickly to reverse this drastic cut to our ability to provide the best care for our patients" (Newman, Baltimore Sun, 7/7).

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.

© 2008 Advisory Board Company and Kaiser Family Foundation. All rights reserved.

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