Medicare Pricing Frozen As Congress Leaves Town

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By Paul Kane
Washington Post Staff Writer
Saturday, June 28, 2008

With congressional leaders engaged in heated brinkmanship, the Bush administration yesterday gave a reprieve to thousands of doctors expecting to get hit Tuesday with a 10.6 percent cut in Medicare payments.

The Department of Health and Human Services will essentially freeze the current pricing system because Congress left town yesterday for a midsummer break without approving a price fix, Secretary Mike Leavitt announced. Congressional aides said the freeze could last 10 days.

If the legislative dispute lasts beyond the new deadline, Leavitt said he hopes to retroactively pay doctors once the dispute is resolved.

But there was no sign of cooling off on Capitol Hill. Yesterday, each side accused the other of playing politics with Medicare, the program that covers many health-care costs for the nation's elderly and some people with disabilities.

Feelings were particularly raw after a Thursday night Senate vote in which members yelled at one another on the floor and left Democrats one vote short of the 60 needed to pass their version of the Medicare fix.

"That display last night on the floor is something I've never seen," said Sen. Arlen Specter (R-Pa.).

The roll call vote was held open for an additional 25 minutes so Sens. Barack Obama (D-Ill.) and Hillary Rodham Clinton (D-N.Y.) could make it to the chamber from their fundraiser at the Mayflower Hotel. Sen. Jim Bunning (R-Ky.) grew irritated about waiting for Clinton, the last to arrive, and called for "regular order" to shut down the vote. That led to a shouting match with Sen. Robert C. Byrd (D-W.Va.), who yelled "Who are you?" and mockingly called his colleague a "great baseball man."

Bunning, a Hall of Fame pitcher in the 1950s and 1960s, shouted back that he has the same rights on the floor as Byrd, the longest-serving senator in history and the chamber's leading parliamentary expert. The exchange ended with Byrd loudly laughing.

The payment cuts to doctors are part of a 1997 balanced budget deal that trims the money going to Medicare, but the doctors have regularly staved off the cuts.

They argue -- through their lobby, the American Medical Association, and the AARP -- that slashed payments would prompt many doctors to drop out of the system. Private insurance companies make a similar argument for Medicare Advantage, a program of private fee-for-service insurers and HMOs that is targeted in the Democrats' bill.

By reducing funding for Medicare Advantage, the Democrats would pay for postponing the pay cut to doctors for 18 months. The legislation could result in $14 billion less for insurers over five years, though an estimate by a conservative House Republican caucus put the tally at $47.5 billion over 11 years.

The White House has threatened a veto over Medicare Advantage cuts, arguing that the Senate Finance Committee is close to working out a compromise without cutting payments to private insurers in that program.

Those negotiations, between Sens. Max Baucus (D-Mont.), the Finance Committee chairman, and Charles E. Grassley (R-Iowa), broke down when Senate Majority Leader Harry M. Reid (D-Nev.) decided to push ahead with the House bill after it passed that body Tuesday by a veto-proof margin.

Aides said yesterday that no new talks had begun, and after the Senate reconvenes July 7, it will have three days to pass a fix before the HHS freeze is lifted.

At one point during Thursday's debate, Reid literally hopped around the chamber, predicting Democrats would hold "at least" 59 Senate seats next year because Republicans toed Bush's line.

"I don't know how many people are up here for reelection, but I am watching a few of them pretty closely," Reid said, staring at the GOP side of the chamber. "I say to all those people who are up for reelection: If you think you can go home and say, 'I voted no because this weak president, the weakest political standing since they have done polling, I voted because I was afraid to override his veto' -- come on."

Minority Leader Mitch McConnell (R-Ky.), visibly angered by Reid's speech, offered temporary legislation that would forestall the pay cuts to doctors through July, but Democrats objected. Yesterday Jim Manley, Reid's spokesman, mocked Leavitt's 10-day delay "as nothing more than a fig leaf" to offer political cover to Republicans.


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