Committee Markups on House GOP Medicare Package Could Be This Week, CQ Reporter Goldreich Says

Returning after the weeklong Memorial Day recess, House Republicans are expected to have a Medicare package, which includes a drug benefit, ready for committee markups this week, Congressional Quarterly senior reporter Samuel Goldreich says in this week's "Congressional Quarterly Audio Report." To help push the package to a floor vote, Republicans have pledged to increase Medicare payments to hospitals by $9 billion over 10 years instead of cutting them by $17 billion, as contained in earlier drafts of the legislation. In doing so, House Ways and Means Chair Bill Thomas (R-Calif.) and Energy and Commerce Committee Chair Billy Tauzin (R-La.) have "decided not to pay President Bush's zero-sum game," under which the president said that any increases in Medicare payments for one provider group would have to be offset by cuts for another group, Goldreich says. Republicans insist that increasing hospital payments would not impact funds for a drug benefit, pointing out that the Congressional Budget Office has said the drug benefit would produce 30% savings because it would foster competition through private insurers offering drug-only policies. However, Goldreich says that Senate Democrats are "dubious" of such claims and call the CBO analysis "faulty." Senate Majority Leader Tom Daschle (D-S.D.) has promised floor consideration this summer of drug cost legislation, including a Medicare drug benefit. However, Goldreich says that there might "never" be any "real" action in the Senate on prescription drugs because it will be difficult for either Democrats or Republicans to gain the 60 votes necessary to end debate on a prescription drug benefit and force a vote on the legislation. Besides a Medicare prescription drug benefit, Senate Democrats are considering measures to allow reimportation of U.S.-made medications from Canada and drug patent reform. Goldreich says the chances of any of the drug issues passing is "close to zero."

Cloning, Uninsured
Goldreich also lists health care issues still facing Congress, including a ban on human cloning, which was passed by the House last year, and the uninsured. Goldreich predicts there will be a "strong push by conservatives" for the Senate to schedule a vote on such legislation. Daschle earlier had promised a floor debate by March or April. Goldreich notes that the "big problem" is that neither Democrats nor Republicans have the necessary 60 votes to end debate and force a vote on the issue, so action on a human cloning ban could "slip a few more weeks." As for the uninsured, health benefits for trade-displaced workers approved by the Senate as part of an overall trade bill could "get watered down" in conference committee because conservative Republicans don't like the idea of forcing unemployed workers onto employer plans (Goldreich, "Congressional Quarterly Audio Report," 6/3). The Senate bill would provide as many as 100,000 uninsured trade-displaced workers with advanceable tax credits to cover up to 70% of the cost of health insurance premiums. The workers could use the tax credits to purchase health insurance through COBRA -- the 1986 Consolidated Omnibus Budget Reconciliation Act, which allows unemployed workers to retain employer-sponsored health coverage by paying 102% of the premiums -- or through group health insurance pools established by states. The trade bill approved by the House does not include health benefits (Kaiser Daily Health Policy Report, 5/24). Goldreich's full report is available online.