As After Pearl Harbor, Terrorist Attacks Likely to Slow Health Policy Legislation, CQ’s Goldreich Says

In this week's "Congressional Quarterly Audio Report," senior reporter Samuel Goldreich discusses the impact of last week's terrorist attacks on several health policy issues. Examining current spending, Goldreich says lawmakers' decision to draw money from the Medicare and Social Security surpluses to support the general budget as the nation gears up to battle terrorism won't hurt Medicare benefits, at least in the short term. He explains that "Congress simply returned to the age-old practice of disposing of surplus funds from whatever their source and writing IOU bonds to cover future benefit checks for Medicare and Social Security." But at some point, lawmakers will have to revisit the "lockbox issue" so that paying off those IOUs doesn't ultimately overwhelm the budget. Goldreich adds that even if Congress, consumed with national security matters, fails to pass this year's appropriations bills by a Sept. 30 deadline, lawmakers will likely pass a continuing resolution to keep government agencies operating, meaning Medicare and Medicaid payments would not be disrupted.

Guns vs. Butter
Looking ahead, Goldreich says that Congress is unlikely to move this year on any of the health policy issues drawing attention before the attacks, such as patients' rights, stem cell research funding and a Medicare prescription drug benefit. A planned Sept. 21 hearing by the House Energy and Commerce Committee's health and oversight subcommittees on problems with Medicare drug reimbursement may raise some questions about the program's ability to add a more comprehensive drug benefit, but lawmakers will probably not have enough time to delve much further into the issue this year. While Congress managed to "do both guns and butter" during the Vietnam war -- spending on both defense and "Great Society" programs such as Medicare -- lawmakers today are more reluctant to be "tagged with squandering taxpayer money just when they [have] finally put an end to decades of ever-increasing deficits." A better parallel, Goldreich says, is to the impact on domestic programs following the attack on Pearl Harbor. Goldreich notes, "I looked up what [else] was happening the week of that first day of infamy in 1941 and found that the five-year-old Social Security Administration was lobbying for a massive expansion of benefits to include disability coverage. That passed, of course, but not until 1954." Drawing comparisons, Goldreich says that "it might take a few more years" for Congress to pass substantial Medicare reforms. Goldreich's full report can be heard online ("Congressional Quarterly Audio Report," 9/17).