HealthLawProf Blog

Editor: Katharine Van Tassel
Concordia University School of Law

Tuesday, July 15, 2008

Bush Vetoes Bill Protecting Doctors From Medicare Cuts

CNN reports that Bush has vetoed last week's approval of the Medicare Bill, which would have prevented cuts in Medicare payments to doctors.  Prospects of a veto override in the Senate are unclear.  CNN writes,

Bush_3President Bush has vetoed a bill that would have protected Medicare payments to doctors from being cut, White House press secretary Dana Perino said Tuesday.

The bill would reverse a 10.6 percent cut in Medicare payments to doctors. The cuts in Medicare payments -- part of a scheduled cost-saving formula -- went into effect July 1, although the Bush administration said it would hold off processing claims until mid-July to give Congress time to reach a compromise on the legislation.

The House of Representatives last month passed the bill 359-55 -- considerably more than the 290 votes needed to override a veto.

The prospects for a veto override in the Senate are murkier.

A filibuster held up the bill before being broken by a 69-30 vote Wednesday. Sixty-seven votes are needed to override Bush's veto. But there's no guarantee that all the senators who voted to end the filibuster would vote to override the veto.

Similar cuts were scheduled to go into effect on July 1 in previous years, but Congress always voted to stop the cuts.

While the debate was raging over the bill, a major doctors' group said the cuts could lead to a "meltdown" of the government's health care system for the elderly.

At the heart of the dispute is the decision by Democratic lawmakers to pay for the "doctors' fix" by cutting funds for Medicare Advantage, a program administered by private insurance companies that is generally favored by Republicans and opposed by Democrats.

The program, which has more benefits than traditional Medicare, is also more expensive.

Republicans -- joined by the insurance industry -- fear Democrats are trying to weaken the Medicare alternative by draining funds away from it.

The Medicare system pays for the health care of roughly 40 million elderly Americans. Rising health care costs have made Medicare a growing part of the federal budget, and the stress on the system is increasing as more baby boomers reach retirement age.

The American Medical Association, a powerful doctor's group, said its members may be forced to reduce service to Medicare patients if the cuts go into effect.

According to a recent association survey, 60 percent of physicians will be forced to limit the number of new Medicare patients they can take on if the cuts go into effect.

"We stand at the brink of a Medicare meltdown. ... For doctors, this is not a partisan issue -- it's a patient access issue," AMA President Nancy Nielsen said in a statement after last week's Senate vote.

The AMA ran radio and TV ads over the July Fourth congressional recess targeting 10 Republican senators, seven of whom are up for re-election.

The AARP, the nation's largest organization of retired persons, and other groups also are weighing in against the cuts.

Gerald Harmon, a family physician who practices in Pawleys Island, South Carolina, said the cuts could lead to doctors taking fewer Medicare patients, making it difficult for the program's elderly patients to get the care they need.

"This Medicare access problem is a real issue, not just a political football," said Harmon, who said 35 percent of his patients were eligible for Medicare. "It affects your dad, when he's sick. It affects my patients in my practice. This has to be addressed."

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