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The White House issued a veto threat against a House bill that seeks to prevent a steep cut in Medicare fees to physicians and is scheduled for a vote Tuesday. Although the veto threat was expected, it underscores the difficulty facing Congress as it tries to complete its work on Medicare before recessing for Independence Day. If the House and Senate fail to deliver a bill that President Bush will sign, physicians will see their pay rates automatically cut by 10.6 percent on July 1. Later Tuesday, the House plans to take up the legislation under the suspension calendar, meaning Democrats would have to count on about 50 Republicans voting against their own leadership and the White House to pass the bill. In a Statement of Administration Policy released Tuesday morning, the White House spells out numerous objections to the House bill, which is sponsored by Ways and Means Committee Chairman Charles Rangel (D-N.Y.) and Energy and Commerce Committee Chairman John Dingell (D-Mich.). The foremost problem with the bill, according to the White House, is the changes Democrats seek to make to Medicare Advantage, the program through which private health insurance plans provide health benefits to enrollees. “The administration has repeatedly communicated that legislative proposals that result in loss of beneficiary access to additional benefits or choices in the [Medicare Advantage] program are unacceptable,” the statement says. The statement also notes that the White House used the same rationale to threaten to veto a bill sponsored by Senate Finance Committee Chairman Max Baucus (D-Mont.), which forms the basis for the House legislation. The Senate failed to advance Baucus’s bill earlier this month. Baucus and Finance Committee ranking member Chuck Grassley (R-Iowa) currently are engaged in talks on a consensus package they hope to move this week. Like the Baucus measure, the House bill would make several modifications to the program, chiefly by mandating that one type of Medicare Advantage plan, called private fee-for-service, assemble networks of physicians, hospitals and other medical providers that agree to serve their patients. Other types of plans, such as HMOs, already create such networks but private fee-for-service plans currently do not have to. Democrats say these provisions would be fairer to providers and would stem the growth of private fee-for-service plans, which are the fastest-growing Medicare Advantage plans and the costliest to the government. The House Republican leadership also is attempting to focus lawmakers’ attention on private fee-for-service Medicare Advantage plans. A release issued Tuesday by Ways and Means Committee ranking member Jim McCrery (R-La.) lists more than 130 congressional districts — mostly Republican — and details the percentage of Medicare Advantage enrollees in each one that belong to private-fee-for-services plans. |
