Bush To Veto Any Legislation Including Medicare
Advantage Cuts
Health and Human Services Secretary tries to stop
Democrat bill restoring physicians pay cut
May 30, 2008 -
HHS Secretary Mike Leavitt
in a May 22 letter wrote that President Bush's senior advisers would
recommend he veto any legislation that "would result in the loss of
access to additional benefits or choices in the Medicare Advantage
program," the
AP/San Francisco Chronicle
reports (Freking, AP/San Francisco Chronicle, 5/29).
The letter was sent to
Senate Finance
Committee ranking member Chuck Grassley (R-Iowa) after
bipartisan discussions on a Medicare bill halted last week (Edney,
CongressDaily, 5/29).
Finance Committee Chair Max Baucus (D-Mont.) last
week said he will move forward with a Medicare package developed by
Democrats that likely will be opposed by Republicans and the Bush
administration. Baucus said he is retreating from crafting a bipartisan
Medicare package that would delay for 18 months a 10.6% cut to physician
fees.
Although both parties want to halt the cut, which
is scheduled to go into effect on July 1, they have been unable to agree
on offsets to pay for the bill, among other issues (Kaiser
Daily Health Policy Report, 5/22).
According to the AP/Chronicle, lawmakers must find
at least $9 billion in offsets over the next five years from other
Medicare programs. The AP/Chronicle reports that Democrats and some
Republicans favor making cuts to payments for MA plans, which cover
about 9.5 million beneficiaries.
Baucus spokesperson Carol Guthrie said advisory
commissions have said the government on average pays MA plans 13% more
than it would spend on comparable patients enrolled in traditional
Medicare. Guthrie said, "Congress has a duty to Medicare beneficiaries
and to all taxpayers to modify payments when they are found to be out of
line" (AP/San Francisco Chronicle, 5/29).
According to CongressDaily, reducing MA plan
payments is an "attractive fundraiser" to offset the delay in physician
fee reductions, especially with Democrats, "who are not as supportive of
private-sector participation in Medicare." Grassley and Senate Minority
Leader Mitch McConnell (R-Ky.) last week offered a Medicare package that
would cut $8.7 billion in MA payments for indirect medical education (CongressDaily,
5/29).
Administration 'Strongly Opposes' MA Cuts
The Bush administration has said reducing MA
payments would result in reduced benefits for beneficiaries (AP/San
Francisco Chronicle, 5/30).
Leavitt wrote, "To protect the interest of these
beneficiaries, the administration strongly opposes any policies that
would reduce payments for MA plans or target a subset of those plans for
funding reductions, program restructuring, marketing restrictions or
enhanced state regulation" (CongressDaily, 5/29).
Leavitt wrote that offsets should be found through
cuts to traditional Medicare fee-for-service plans (AP/San Francisco
Chronicle, 5/30). According to CongressDaily, although Leavitt's letter
did not specifically mention MA IME cuts, the "sweeping" opposition to
MA payment reductions combined with Leavitt's letter "conjures up doubt
that any reductions in the IME payments would pass muster" (CongressDaily,
5/29).
Letter 'Complicates Efforts' To Find Offsets
According to the AP/Chronicle, Leavitt's letter
"complicates efforts" by lawmakers to find offsets to maintain or
slightly raise current physician payment rates. Already it is "tough to
find enough votes to cut payments to any health care provider in the
Medicare program, let alone find enough support to overcome a
presidential veto," the AP/Chronicle reports (AP/San Francisco
Chronicle, 5/29).
