Groups opposed to Medicare, Medicaid cuts strategize

Some opponents of the Medicaid and Medicare provisions of the budget-reconciliation bills headed to conference committee are huddling this week to determine what strategy to employ to block cuts to the programs.

Groups such as AARP intend to focus their efforts on urging the as-yet-unnamed conferees to move closer to the Senate provisions, which eschew directly placing additional burdens on beneficiaries enrolled in the programs in favor of targeting the healthcare industry.

AARP plans to continue tactics it has employed all year on the budget, said David Certner, AARP’s director of federal affairs. Advertising inside and outside the Beltway has been effective in getting out the message, he said, and will likely be a part of the AARP’s ongoing effort, he said. The group will target members based on how they voted, he added, and plans to hold a media briefing at its Washington headquarters Friday.

AARP’s huge membership is famously tenacious and influential, having helped pass the 2003 Medicare drug bill and derail Social Security reform this year.

Certner said he expects Congress to be subjected to “continued grassroots pressure from back home.” Another AARP spokesman remarked that some congressional offices have pleaded with the group to ask its members to stop calling.

Others groups, such as the retail pharmacy and pharmaceutical lobbies, face a more difficult challenge. These industries stand to lose regardless of which policies might be chosen because both the House and Senate voted to reduce Medicaid payments for prescription drugs.

“Neither address pharmacy’s concerns,” said Kristina Lunner, director of federal government affairs for the American Pharmacists Association (APhA).

Having failed to eliminate those provisions during committee and floor negotiations, these interest groups hope to devise a way of influencing the final outcome of the debate without exposing themselves to the ire of the GOP leadership by being viewed as obstructing a bill that is a top priority for the conservative Republicans and the White House.

The National Association of Chain Drug Stores (NACDS), along with other organizations representing pharmacies and pharmacists, has been among the most strident foes of the proposed changes to Medicaid payments for drugs. The NACDS created the Coalition for Meaningful Medicaid Reform earlier this year with the National Community Pharmacists Association, APhA and a slew of other pharmacy groups and retailers.

The pharmacy coalition has employed an aggressive and multifaceted campaign attacking both the House and Senate bills that included a lengthy series of strongly worded statements and inside-the-Beltway advertisements that maintained that the drug-payment cuts would limit patients’ access to pharmacists.

The groups quieted their efforts as the House marched toward a difficult but ultimately successful vote on its version of the budget bill. It is preparing to turn up the volume in anticipation of an eventual conference report.

Rep. Walter Jones (R-N.C.) voted against the budget reconciliation bill partly because he was concerned about how it would affect community pharmacists, according to his spokeswoman.

The NACDS conducted a conference call Monday with its member companies. The coalition members were slated to convene yesterday to determine what would be their next steps.

The best possible outcome for the pharmacies, and the drug makers, would be if Congress were unable to take final action on the budget bill. That scenario could unfold, given that the measure barely passed the House and that the two versions of the legislation are vastly different.

But the pharmacies still do not want to take a position against reconciliation itself. “We’re not going to just say, ‘OK, we’re not going to support this at all,’” an NACDS spokesperson said.

The pharmacies were given a small concession by the House leadership prior to the vote when a “safety valve” was added to the bill, the spokesperson said. The language is intended to ensure that pharmacists, at a minimum, are reimbursed for the cost of the drugs they dispense. The pharmacy coalition, however, did not view this provision as an adequate redress of its concerns.

The pharmacists particularly object to the implication that their services do not deserve recognition and financial compensation, Lunner said.

Kipp Lanham contributed to this report.