Senate Majority Leader Reid Seeks Vote on House Medicare Package Before July 4 Recess

Senate Majority Leader Harry Reid (D-Nev.) said passing a measure to halt a 10.6% reduction to Medicare physician fees scheduled to go into effect July 1 is a priority before the Fourth of July recess but had no specific plan to do so as of Wednesday, CQ Today reports. Senate aides and lobbyists expect Reid to seek an agreement to hold a vote on Medicare legislation (HR 6331) passed by the House on Tuesday.

CQ Today reports that "it is unclear when the Senate might be able to turn to the Medicare legislation" if Republicans do not agree to a vote on the House bill (Armstrong, CQ Today, 6/25). The House measure includes payment reductions to so-called fee-for-service Medicare Advantage plans, which the Bush administration opposes and caused many Republicans to vote against a similar measure (S 3101) proposed by Senate Finance Committee Chair Max Baucus (D-Mont.).

Baucus on Wednesday said he supports the House-approved Medicare bill, despite a compromise bill he was developing with Finance Committee ranking member Chuck Grassley (R-Iowa). Reid on Wednesday said that the only Medicare measure senators might get to vote on before the recess is the House-approved bill. Grassley said he is uncertain whether the compromise measure he and Baucus worked out would be voted on if the House bill does not pass the Senate. Barring opposition from Republicans, the Senate could hold a vote on the House measure on Thursday or Friday, according to CongressDaily (Edney, CongressDaily, 6/26).

If the Senate does not approve the House bill, Congress could take up the issue again after the recess and pass legislation that retroactively restores the physician fee cut. However, such a move "could create headaches" for CMS officials and could disrupt payments to physicians, according to CQ Today (CQ Today, 6/25).

Editorial
The "annual scramble" to delay reductions to Medicare physician fees "offer[s] opportunities for legislative mischief but also leverage for legislative achievements," according to a Washington Post editorial. The editorial states, "The achievement comes in the form of restrictions on" MA plans -- the "fastest-growing segment of Medicare" that enroll more than 20% of beneficiaries -- that are paid on average 13% more than traditional Medicare. According to the Post, the "most wasteful" of the MA plans are the so-called private fee-for-service plans, which on average are paid 17% more than traditional Medicare.

The editorial states that the recently passed House bill "would level the MA playing field, ever so slightly," by enacting some of the cost controls and quality requirements imposed on other MA plans, reducing Medicare expenditures by an estimated $13.6 billion over five years. The Post states that such reductions would be a "small but significant step" but that it has been "strenuously resisted by the insurance industry and the Bush administration."

Meanwhile, the measure also includes provisions that expand Medicare benefits -- such as increasing physician fees, expanding preventive care and simplifying the qualification process for low-income beneficiaries -- during a time when the program should be containing costs. However, "these targeted improvements are justifiable and paid for," according to the Post. The Post concludes, "We would rather see the money going to Medicare beneficiaries than to the insurance companies and equipment suppliers now profiting so handsomely from the program" (Washington Post, 6/26).