Congress May Act on Medicare Provider Payment Cuts, But Drug Benefit Progress Unlikely, CQ’s Goldreich Says
Returning from recess, congressional lawmakers are bringing back messages about health care concerns from multiple sources -- employers facing rising costs, "anyone who pays for prescription drugs" and providers contending with cuts in Medicare reimbursement, Congressional Quarterly's Samuel Goldreich says in this week's "Congressional Quarterly Audio Report." But only the last issue is likely to be successfully addressed this year, Goldreich says. Goldreich calls the provider payment cuts of 5.4%, which took effect Jan. 1 under a formula approved by Congress in 1997, the "most pressing problem" of the three and predicts lawmakers will move on the issue before bigger scheduled cuts take place on Oct. 1.
Action Possible on Uninsured
In addition, Goldreich notes that legislators may be able to reach agreement this year on helping the uninsured. Key to this issue, he notes, is lobbying from "two powerful groups": the National Governors Association and employers led by the Chamber of Commerce. Though the former seeks a Medicaid bailout and the latter favors tax credits -- a disagreement that helped sink insurance relief in last year's economic stimulus talks -- lawmakers are now "looking at running for reelection without making any progress on one of the major health issues that has bedeviled Congress for the last 10 years." With $89 billion included for health insurance tax credits in President Bush's budget proposal, agreement is possible if both sides "agree to make a trade that would allow the other party to walk away winners."
Rougher Sailing for Medicare Drugs
Goldreich is less optimistic on prospects for a Medicare drug benefit, saying it "might be in place when I'm 65 in 22 years." Although both the House and Senate have approved budget resolutions supporting at least $350 billion over 10 years for the benefit, such resolutions are "basically guidelines" that "have no real impact" on what appropriations are actually made later in the year. In both houses, Goldreich notes, legislators drafting drug benefit plans are facing a "waiting game," delaying bill introductions until they see whether funds will be available. He adds that even if the $350 billion is ultimately appropriated, the AARP contends the funding will fall short of the "more realistic" $750 billion needed to create a drug benefit with out-of-pocket costs that seniors will accept. And "on top of all this," a "wide gulf" remains between the parties on how to structure the benefit, with a Republican-backed expansion of drug coverage through private managed care plans opposed by most Democrats. Goldreich's full report is available online ("Congressional Quarterly Audio Report," 4/8).
