CQ TODAY PRINT EDITION
– HEALTH
July 8, 2008 – 8:36 p.m.
Democrats Still in Search of One More GOP Vote on Medicare ‘Doctor Fix’
By Drew Armstrong, CQ Staff
Senate Democrats are giving Republicans another take-it-or-leave-it offer going into Wednesday’s vote to rescind a scheduled cut in Medicare’s fees to doctors.
They are refusing to consider GOP amendments in exchange for the elusive 60th vote needed to put the bill (
Some Republicans, notably Arlen Specter of Pennsylvania, have sought opportunities to amend the bill and have said that was the reason they voted against proceeding to the measure June 26.
Democrats that day fell one vote short of the 60 needed to proceed to and pass the bill, which would stop a 10.6 percent cut to doctors’ Medicare payment rates.
Majority Leader Harry Reid , D-Nev., shut down speculation about the possibility of amendments.
“The answer is no,” Reid said. “If we don’t get 60 votes, the Republicans are going to have to live with that.”
Democrats said they would keep leaning on the other side to come up with the final “aye” for this week’s vote.
“We’re trying to pick up an additional Republican vote — we need one,” said Majority Whip Richard J. Durbin , D-Ill., adding, “We hope it’s John McCain .”
McCain, R-Ariz., did not vote June 26. A spokesman said he would not be at Wednesday’s vote but declined further comment. McCain’s likely opponent in this fall’s presidential race, Barack Obama , D-Ill., voted for the measure in June, and a spokesman said Obama would be voting the same way Wednesday.
The Democrat who was missing June 26, Edward M. Kennedy of Massachusetts, is being treated for cancer and will not be back for Wednesday’s vote.
The Military Health Care Argument
Democrats are attempting to tie the physician cut issue to support for the troops, using the relationship between Medicare and the military health program Tricare, which borrows its physician payment rates from Medicare. As a result, physicians paid under Tricare also face a 10.6 percent cut. Advocates for rescinding the Medicare cut say that the lower payment rate threatens soldiers’ access to health care.
The physician pay cuts for Medicare and Tricare technically went into effect July 1, but the administration has temporarily postponed both. The Medicare cuts have been delayed until July 15, while the cuts to Tricare physician pay have been postponed indefinitely, according to a spokeswoman for Max Baucus , D-Mont.
Democrats Still in Search of One More GOP Vote on Medicare ‘Doctor Fix’
No End to Tough Talk
Analysts widely expect that the two sides eventually will come together and halt the cuts, but that has not stopped the tough talk.
Baucus continued to raise the specter that doctors might stop treating senior patients if the cuts go through after the administration’s current stay. “There’s no way they’ll be able to continue seeing this population,” Baucus said.
Many Republicans were out of town Tuesday, attending the funeral of former North Carolina Republican Sen. Jesse Helms (1973-2003), so they weren’t around to be personally lobbied on the so-called doctor fix legislation.
If 60 senators vote Wednesday to proceed to the bill, it is expected to have enough votes for passage as well, but that may not matter.
Despite an overwhelming House vote of 355-59, the administration has threatened to veto the measure.
“There’s been no change in our position,” White House spokesman Tony Fratto said Tuesday.
The White House adamantly opposes the offsets in the bill, which would cut bonus payments to private Medicare plans known as Medicare Advantage. The bonus payments, which go to private plans that have teaching hospitals in their service area, are known as “indirect medical education” payments.
The bill also would limit a subset of the private plans — so-called private fee-for-service plans — in their ability to use a process through which health care providers not explicitly enrolled in the plans could be forced to accept the plan’s payment levels whenever they treat a covered patient.
The White House is against such changes and has laid out its concerns in several official position statements.
The most recent Statement of Administration Policy, issued June 26, said the White House “strongly opposes” the current bill because of “inappropriate reductions in Medicare Advantage payments.”
Democrats have long sought to cut payments to the plans, which get a higher rate than traditional Medicare. The White House and many Republicans believe that the plans will eventually lower costs through competition.
Kathleen Hunter contributed to this story.
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