GOP seizes on Medicare fears

Republicans opened up a new front in the battle for the hearts and minds of the all-important senior-citizen voting bloc Wednesday during the Senate Finance Committee’s markup of healthcare reform legislation.

In an odd sort of role reversal, Republicans who traditionally have railed against out-of-control entitlement spending and sought to scale back Medicare are positioning themselves as champions of the program.

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The $900 billion bill, authored by committee Chairman Max Baucus (D-Mont.), reduces Medicare spending by $300 billion by cutting payment rates to medical providers and subsidies to private insurance companies in the Medicare Advantage program. The cost savings would help finance expanding coverage to tens of millions of uninsured.

Committee Democrats argued, as President Barack Obama has, that the bill does not call for any reduction in benefits under traditional Medicare and that the cuts target inefficiency and overpayments.

“There’s not one red cent cut in this bill” for Medicare benefits, Baucus said.
Senior citizens have proven to be the most skeptical segment of society when it comes to healthcare reform. Obama knows it and has repeatedly assured older Americans that his plan will not harm their Medicare benefits.

“Look, here’s the bottom line. You’re going to be better off — you, all of us who qualify for Medicare — are going to be better off under the reforms we’re proposing, not worse off,” Vice President Joe Biden said during an event at a seniors center in suburban Maryland with Health and Human Services Secretary Kathleen Sebelius.

And the healthcare reform bills under consideration would lower prescription drug costs and expand preventive benefits, Finance Committee Democrats noted.

But the message has not gotten through and seniors remain in play, despite Obama’s efforts.

Not even the AARP, which has spent millions of dollars to promote healthcare reform, can put older Americans at ease. The organization, vulnerable to backlash from a population that favored Sen. John McCain (R-Ariz.) in last year’s presidential contest, has yet to endorse any of the Democrats’ healthcare bills.

Biden took aim at Republicans for presenting themselves as guardians of Medicare: “They were nowhere to be heard in the ’80s and ’90s when we were trying to protect Medicare.

“I find it absolutely fascinating these guys who wanted to cut Medicare before, these guys who didn’t like it in the first place are now out there telling you that this is the best thing that ever happened since sliced bread,” said Biden.

But the Obama administration and its allies on Capitol Hill still face the challenge of persuading seniors to join the healthcare reform bandwagon and that the cuts are aimed at waste and inefficiency, not designed to take away their Medicare benefits.

Republicans on the Finance Committee seized on this perceived political advantage during the markup Wednesday, offering numerous amendments designed to preserve the proposed cuts in Medicare spending.

“It’s a wonderful way to make Medicare solvent by basically slashing all [provider] reimbursements so they don’t treat Medicare beneficiaries,” said Sen. Pat Roberts (R-Kan.).

Sen. Orrin Hatch (R-Utah) and others said that Baucus’s proposal to slash Medicare Advantage subsidies by $123 billion over 10 years and subject the companies to competitive bidding would inevitably result in beneficiaries losing the extra benefits they currently enjoy, such as vision coverage.

“There is a strong possibility that Medicare Advantage beneficiaries will lose benefits under competitive bidding,” said Hatch, who proposed leaving the funding at current levels. Any reductions to those benefits would violate Obama’s pledge that no one would lose his or her current coverage under healthcare reform.

Baucus repeatedly insisted that none of the cuts to Medicare payments for providers would affect benefits for enrollees. As for Medicare Advantage, Democrats said, the extra benefits provided by those insurance plans are the direct result of overly generous subsidies.

“This is a rip-off,” said Sen. Jay Rockefeller (D-W.Va.). “It’s a wasteful, inefficient program and it always has been.”

Democrats note it costs more to cover someone in Medicare Advantage than in traditional Medicare. The Baucus bill would subject Medicare Advantage plans to a competitive bidding process that is designed to lower spending on the program.

According to government auditors, the subsidies for Medicare Advantage make it an average of 14 percent more costly per beneficiary. In addition, because of the way premiums are calculated, people in traditional Medicare pay an additional $3.60 a month because of high Medicare Advantage costs, Baucus said.

Baucus worked with Republicans to draft the 2003 bill that boosted Medicare Advantage funding, but on Wednesday called it a “mistake.”

Sen. Bill Nelson (D-Fla.) has also expressed concern about the cuts in Medicare Advantage funding but has proposed a targeted remedy that would only “grandfather” existing enrollees. “You’re supporting the wrong amendment,” Nelson said to Hatch.

None of the Republican amendments on Medicare funding passed. Sen. Olympia Snowe (R-Maine) voted with Democrats against Hatch’s amendment and against Sen. John Cornyn’s (R-Texas) amendment to eliminate Baucus’s proposed independent Medicare policy-setting commission.

The second day of the committee’s markup of the bill proceeded even more sluggishly than the all-day session that kicked off the markup Tuesday. After spending nearly two hours debating committee procedure, senators voted on a handful of the more than 500 amendments pending before breaking for dinner.

“There is a substantial slow-walk that is going on in this committee,” Rockefeller complained.

Nearly the entire first two hours of the markup Wednesday were consumed by a debate on whether the committee should abandon its standard practice of considering plain-English “conceptual” language and instead use formal legislative language.

Baucus asserted that there is no reason for the committee to change its practices. “We’ve never, ever, ever, ever done that in this committee,” he said. Sen. John Kerry (D-Mass.) accused Republicans of merely trying to slow down the bill. “This is fundamentally a delay tactic,” he said.

Republicans, including Snowe, insisted that the bill is too important to allow any uncertainty to creep into the process. “That we didn’t do it before is not a rationale for not doing it now.” she said. “If it takes two more weeks, it takes two more weeks.”