Clinton, GOP Continue to Feud over Medicare Givebacks

As they push toward the end of the congressional session, GOP leaders on Oct. 25 unveiled a new package of tax proposals that includes a $31 billion "Medicare giveback" bill to restore some funding to hospitals, nursing homes and other Medicare providers cut by the 1997 Balanced Budget Act, the Washington Post reports. Republican lawmakers have added $3 billion to their previous $28 billion proposal, but President Clinton "has repeatedly complained" that the payments will "disproportionately" go to Medicare HMOs at the expense of providers. "I have no objection to the HMOs being given consideration in this bill. The only point I tried to make is that if you give them as much money as the Republicans do, you severely short the urban and rural hospitals, the teaching hospitals and other providers," Clinton told reporters yesterday. Under the Republican proposal, $11.1 billion would fund Medicare+Choice, the "controversial" Medicare managed care program. Senate Minority Leader Thomas Daschle (D-S.D.) noted that Clinton would likely veto the entire package "unless the administration is satisfied with the makeup of the Medicare funding" (Morgan/Pianin, Washington Post, 10/26). Responding to the giveback proposal, Rep. Pete Stark (D-Calif.) said that "[s]eniors are being duped" by Medicare HMOs that do "not expand their choice of health care providers, [but do] the opposite." As a result, Stark announced that he is "introducing legislation to make clear to all Medicare beneficiaries that the Medicare HMO program doesn't deserve the title Medicare+Choice. ... It changes the name of the Medicare HMO program ... to the Medicare-No-Choice program" (Stark release, 10/25). GOP leaders, however, said Clinton would be "hard-pressed" to veto the tax package, as it also contains such benefits as a $1 increase in the minimum wage and an increase in Individual Retirement Account limits. "I find it frankly unfathomable [Clinton] would veto that bill," Senate Majority Leader Trent Lott (R-Miss.) said (Washington Post, 10/26). The GOP legislation also would provide tax relief for the cost of health care, allowing a new deduction for health insurance premiums paid by individuals not covered by employer-based plans. Clinton and Democrats "strongly oppose" these deductions, saying that they would "do little to reduce the ranks of the uninsured," many of whom lack the income to pay taxes. Tax credits may be a better solution, they contend, as credits "would deliver more direct benefits to the people who need it most." Republicans expect to bring the package before the House and Senate later this week (Hook, Los Angeles Times, 10/26).