HealthLawProf Blog

Editor: Katharine Van Tassel
Concordia University School of Law

Saturday, July 12, 2008

White House Vows Veto of Medicare Bill

Writing for the Los Angeles Times, Nicole Gaouette reports on the continued tension over the Senate's approval of the Medicare Bill, which would avert fee cuts to doctors who treat patients under the federal program.  Gaouette writes,

White_house_3The White House on Thursday [July 10, 2008] renewed a vow to veto popular legislation that would avert imminent fee cuts to doctors who treat patients under the federal Medicare program.

The threat came even as Democratic leaders confidently predicted that enough Republicans would side with them to ensure that the bill, which affects 44 million seniors and an additional 9 million military personnel, will become law.

If President Bush does not reconsider a veto, "rest assured that we will make very sure that this bill becomes law through a veto override," said House Speaker Nancy Pelosi (D-San Francisco).

While Democrats and the White House jousted, groups representing seniors pressed the administration to reconsider its veto threat and urged the bill's Republican supporters to help lobby the White House as well.

The Medicare Improvements for Patients and Providers Act would cover the fee cut by taking money from private healthcare insurers. These companies offer Medicare to about 20% of the program's beneficiaries.

Democrats noted that the private insurers charge more than traditional Medicare does, and that the only group to oppose the bill represented private insurers. Republicans countered that private insurers offer seniors more choice.

"Taking choices away from seniors in order to pay for the reimbursement for physicians is the wrong way to pass this bill," said White House spokesman Tony Fratto.

"Does the president still intend to veto this bill?" he asked rhetorically. "The answer is yes."

The American Medical Assn. has found that up to 60% of doctors will begin limiting the number of Medicare patients they see if the reimbursement cut goes into effect July 15. Small annual cuts were part of a 1990s deficit-reduction law, but Congress has almost always waived them. This year, their cumulative effect has risen to 10.6%. Republicans and Democrats agree that the cuts should end, but not on how to do it.

"If the president vetoes the bill, he's taking away the ability of patients to see their physicians, and the ultimate choice is whether a physician is able to see patients," said Dr. James Rohack, the AMA's president-elect.

Rohack said seniors and military families in rural areas would be most affected by the cut in reimbursements.

The military healthcare system, Tricare, bases its reimbursement rates on Medicare, and military groups have said they fear that fewer doctors will be willing to treat active and retired military personnel and their families if Bush vetoes the bill.

The bill passed the Senate in a dramatic vote Wednesday, propelled by the surprise appearance of Sen. Edward M. Kennedy (D-Mass.), who is recovering from surgery for brain cancer. What many expected to be a close vote became a 69-30 rout as one Republican after another -- 18 in all -- lined up to support a bill that had failed by one vote a month earlier.

An identical bill passed the House in June by an overwhelming 355-59 vote. Overriding a veto requires a two-thirds majority of those present and voting in both the House and the Senate.

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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.
which is sponsored by Ways and Means Committee Chairman Charles Range1 (D-N.Y.) and Energy and Commerce Committee Chairman John Dingell (D-Mich.).

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