The Senate Finance Committee voted yesterday to chop $11.8 billion from Medicare outlays over the next three years and to kill the revenue-sharing program as it approved cuts totaling $21.2 billion from 1986 to 1988.
The panel took no recorded votes and debated only briefly as, pressed by Chairman Bob Packwood (R-Ore.), it sped through dozens of major provisions in trying to meet the $38 billion deficit-reduction goal set for those fiscal years by the congressional budget resolution.
In a further effort to reduce the $200 billion annual federal deficit, the panel plans to consider proposals today to raise $15.7 billion through various special taxes and $990 million during the period by letting the Treasury charge people entering the United States a "customs user fee" of $1 to $5.
Sen. Daniel Patrick Moynihan (D-N.Y.) temporarily blocked action on the entry fee, declaring, "You are putting a barrier between the people of Canada and the people of the United States" by charging a Canadian each time he drives perhaps a few hundred yards to cross the border for any purpose, even to visit a favorite hangout for a beer.
The biggest Medicare cut, $6.5 billion over three years, would limit increases in rates paid to hospitals for Medicare patients to one-half of 1 percent in fiscal 1986 instead of the 4 percent they would get if granted enough to make up for medical inflation. In fiscal 1987 and 1988, the increases would be held to the medical inflation rate.
Hospitals normally have received the medical inflation rate plus something extra for patients in Medicare, the health care program for the elderly and individuals covered by Social Security payments.
The House Ways and Means Committee, in approving a similar deficit package, granted a 1 percent increase for 1986. Health and Human Services Secretary Margaret M. Heckler has published a regulation calling for no 1986 increase.
The Finance Committee package includes $400 million in extra payments over the next three years to hospitals with a large share of low-income Medicare patients.
Another provision would cut Medicare payments to hospitals for costs of interns and trainees by $3 billion from 1986-88. Others would freeze payment rates to most doctors for another year, let sick workers over 69 make on-the-job health insurance the primary payer instead of Medicare and hold Medicare premiums at 25 percent of doctor-insurance program costs for 1988.
The $21.2 billion package also includes raising $622 million by increasing from $2.60 per covered worker to $8.10 the premium that the government charges private pension systems to insure the benefits if the pension plan goes bad.
It would cut Medicaid, the health care program for the poor, $316 million over three years by increasing government collections from private insurance policies covering Medicaid patients. Abolition of general revenue sharing with local governments on Oct. 1, 1986, would save $8.5 billion in fiscal 1987-88.