Senate Will Craft Medicare Legislation, Likely To Develop Bare-Bones Package

Main Category: Medicare / Medicaid / SCHIP
Article Date: 17 Dec 2007 - 7:00 PDT

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House Speaker Nancy Pelosi (D-Calif.) on Thursday said that the chamber would wait for the Senate to craft Medicare legislation rather than write its own bill because of continued disagreement among lawmakers on what to include, CongressDaily reports (Johnson, CongressDaily, 12/13). The bill is being written to stop a scheduled 10% reduction in Medicare physician fees scheduled to take effect Jan. 1, 2008.

Pelosi's announcement "represents a concession for Democrats" because it "means the House has essentially given up on a raft of changes to Medicare that had been a priority" for them, according to CQ Today. Senate Republicans had threatened a filibuster as a way to force a Medicare package that would be supported by the White House, conservative Republicans and private health firms, CQ Today reports.

Senate Finance Committee Chair Max Baucus (D-Mont.) on Thursday said the new legislation would not include any cuts to Medicare Advantage plans. Previously, Baucus had said that Medicare legislation would include MA plan cuts. The Bush administration has threatened to veto any legislation containing cuts to MA plans (Armstrong, CQ Today, 12/13). Finance Committee ranking member Chuck Grassley (R-Iowa) on Thursday said Republicans would not accept any Medicare package that contains new policy, only fixes to "present policy." Grassley said he and Baucus earlier in the week agreed to a "pretty slimmed down" package (CongressDaily, 12/14). Baucus said, "It's designed to pass ... and be signed by the president."

Prospects
In addition to stopping the Medicare physician fee cut, the Senate bill could include a small increase to physician payments or none at all, according to CQ Today (CQ Today, 12/13). House Republicans have been pushing for extensions to rural and low-income subsidies, transitional Medicaid assistance and payments for rehabilitative services. It is unclear if the legislation will contain a provision to mandate electronic prescriptions for Medicare, according to CongressDaily (CongressDaily, 12/14). The legislation also likely would extend SCHIP through Sept. 30, 2009. Congress on Thursday approved a continuing resolution that would extend funding for SCHIP program through Dec. 21. The CR that currently is funding the program expired on Friday (CongressDaily, 12/13).

The cost of the measure would be offset by taking money from a "stabilization fund" that is meant to pay private insurers for offering new services to beneficiaries in areas with few Medicare services. It also would draw money from MA payments to hospitals that provide teaching programs. "It's my understanding that the double-dipping in medical education is the only thing the president will approve (directly) out of Medicare Advantage," Grassley said (CQ Today, 12/13).

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