While in Iowa, House Speaker Hastert Explains Bill That Did Not Increase Medicare Payments for State

During a campaign appearance for Rep. Jim Leach (R-Iowa), House Speaker Dennis Hastert (R-Ill.) "defended" a supplemental spending bill approved by the House earlier this year that included provisions to increase the Medicare reimbursements for "certain hospitals" in Pennsylvania and New York, but not Iowa, the Des Moines Register reports. Democrats running for Iowa's congressional and Senate seats have been criticizing Republicans for supporting the bill as Medicare reimbursement rates in Iowa are among the lowest in the nation (Norman, Des Moines Register, 10/31). The $29 billion supplemental funding measure was included in a homeland security and assistance bill for New York after the Sept. 11 attacks. But the additional Medicare funding was stripped out of the final compromise bill (Kaiser Daily Health Policy Report, 10/4). Hastert said, "The problem was exactly what we're talking about -- two hospitals that were exactly half a mile from the metropolitan statistical area, one for Philadelphia and one for New York. They couldn't hire nurses. ... They desperately needed some help." Leach said that Iowa representatives were "discomfited" by the bill's provisions but added that the measure also included funding for national defense, homeland security and health and education assistance, the Register reports. "As a member of Congress, when you look at this, if you are going to say you voted the wrong way, you have to say you're against these other programs," Leach said, adding, "All I can say is in the big picture there's hardly a bill that comes before the Congress that doesn't have one provision or another that is discomforting to every member." Hastert said that Leach and Rep. Jim Nussle (R-Iowa) have been "trying to find ... solutions [to the Medicare equity problem] for a long, long time." Earlier this year, Nussle added a measure that would have increased Medicare reimbursements for non-teaching hospitals in Iowa to Medicare reform legislation that also would have created a prescription drug benefit, but similar legislation stalled in the Senate (Des Moines Register, 10/31).