Chairman of tax-writing panel puts damper on GOP's Medicare overhaul

The chairman of the House Ways and Means Committee said Thursday he has no interest in bringing up House Republicans' proposal to replace Medicare with subsidies for private insurance if it's not going to pass the Senate.

"I'm not really interested in laying down more markers," said Rep. Dave Camp (R-Mich.). "I'd rather have the committee working with the Senate and with the president to focus on savings and reforms that can be signed into law."

Camp made his remarks to reporters at a Health Affairs policy breakfast. They came as Vice President Biden opens up bipartisan talks on raising the debt ceiling.

Camp said he supports the Medicare overhaul put forward by Budget Committee Chairman Paul Ryan (R-Wis.) but that it appears to be going nowhere in the Democratic-controlled Senate.

House Speaker John Boehner (R-Ohio) said camp was being a realist.

"My interpretation of what Mr. Camp said is a recognition of the political realities that we face. While Republicans control the House, the Democrats control the Senate and they control the White House," Boehner said at a Thursday press conference.

He said that Republicans are seeking the changes to Medicare and Medicaid outlined in the 2012 budget and it remains to be seen how far the White House is willing to go in meeting those demands.

Camp put the onus squarely on the White House and Democrats to start offering alternative proposals as part of the debt-ceiling negotiations.

"The debt limit should be coupled with specific savings, including from entitlement programs like Medicare," Camp said. "And if Democrats don't like a premium support model, that's fine; but come to the table with something else. And not something that tinkers around the edges and buys the Medicare program another year or two."

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Some alternatives he mentioned include ideas that have been floated in the past, such as eliminating first dollar support in Medigap and unifying physician and hospital services under one benefit.

Camp suggested that while negotiations should start now, a final deal on Medicare reform won't happen until after the Congress votes to raise the debt ceiling. He acknowledged that changes to Medicare are a potent political weapon for both parties, but said he's confident lawmakers have enough time to reach a bipartisan deal between now and the 2012 elections.

"I do think on entitlements, we need to solve this together," Camp said.

Camp added that he didn't think lawmakers would have enough time this year to permanently repeal the Medicare physician payment system, which would cost almost $300 billion. He also said the idea of repealing Democrats' healthcare reform law was dead.

"Is the repeal dead? I don't think the Senate is going to do it, so I guess yes."

He added that he might be able to support changes to the Medicare system called for in the law, but that it gives too much power to unelected bureaucrats in the Department of Health and Human Services.

The law represents a "massive delegation to the agencies," he said, "and I think that's a problem."

Updated at 12:40 p.m.