Health Care Measures Face Challenges in Congress

With members of Congress distracted by the fight for the presidency and looking ahead to the 107th Congress, legislation involving a patients' bill of rights, Medicare "givebacks" and a Medicare prescription drug benefit are all "hanging like chad" and in danger of not being passed this year, CongressDaily/A.M. reports. The givebacks measure -- which would restore roughly $30 billion in cuts to insurers and providers as part of 1997 Balanced Budget Agreement -- had appeared to be a "must pass issue" for this Congress, CongressDaily writes. But one White House aide asked, now that members have been re-elected, "What's the rush?" That aide gave the legislation an even chance of being passed this year, but one Republican lobbyist said the odds were one in four, and then only if the Medicare provisions were separated from the larger tax bill to which they are attached. Still, hospitals and providers have been steadily lobbying for passage, and some lobbyists believe the legislation will eventually pass "out of fear that some hospitals and health care facilities will have to begin dropping services if they do not have funds for FY 2001." A hospital lobbyist said, "If you look at a laundry list of issues still pending, this is a big one. We're getting strong signals that the leadership wants to separate this out (from the tax bill)." According to Republican "leadership sources," however, no decision has been made and the Republican caucus "remains divided" on how to move the legislation.

Patients and Prescription Drugs
On the patients' bill of rights, "participation and cooperation" within the House and Senate conference had "appeared to be dwindling," and passage appears unlikely this year. Some have suggested that should he become president, Texas Gov. George W. Bush (R) "could try to pass a bipartisan bill quickly to prove he can unite the parties," CongressDaily/A.M. reports. Bush, however, would have to win over "fellow Republicans such as Senate Majority Whip [Don] Nickles" and also sell Democrats on the legislation. An aide to Rep. Charles Norwood (R-Ga.), co-author of the House-passed Norwood-Dingell patients' bill of rights (HR 2723), said, "We need to figure out where there is consensus quickly. Most major issues have a six-month shelf life, or they die a horrible death in gridlock." He added that under a Bush presidency, Democrats would be more likely to compromise on patients' rights legislation because they would no longer have "the backing of the president to argue for more concessions." Finally, a Medicare prescription drug benefit remains "the biggest and most unwieldy health issue of all." Sens. John Breaux (D-La.), Bill Frist (R-Tenn.), Olympia Snowe (R-Maine) and Ron Wyden (D-Ore.) "are sure to revive debate by resurrecting bipartisan bills they introduced earlier this year," yet any proposal will have to emerge from a "harshly divided 107th Congress" (Fulton, CongressDaily/A.M., 12/4).