6/27/2008
Update on Medicare Package and Other Health Care Bills
Medicare Bill:
Last night, Senate Democrats failed to secure the 60 votes necessary to end debate and pass the House-passed Medicare bill. The bill would prevent a 10.6% Medicare payment cut to physicians on July 1st, delay implementation of the Medicare competitive bidding program for durable medical equipment, and provide Medicare mental health parity, among other provisions.
Early this week, frustrated with the Senate’s inaction, the House overwhelmingly approved (355-59) a tweaked version of Senate Finance Committee Chairman Max Baucus’ (D-MT) original Medicare bill, which had previously failed in the Senate. At almost the same time, Chairman Baucus and Finance Ranking Republican, Charles Grassley (R-IA), announced a compromise Medicare bill. However, as the House adjourned for the July 4th recess, Senate Democratic Leadership decided they would only bring the House-passed bill to the floor for a vote.
Prior to the vote, Senate Democrats had secured agreement from the Republicans that if cloture (60 votes) passed then the underlying bill would be agreed to by unanimous consent (essentially approved by voice vote). However, because the Democrats seriously miscalculated the Senate support, the Senate Republicans and Democrats must now return to the negotiation table. The final vote stood at 58-40, with Majority Leader Reid (D-NV) voting against the measure in order to allow future reconsideration. The Senate has adjourned for the week-long July 4threcess and, according to a statement by Senate Majority Leader Reid (D-NV), the Senate will vote on the House Medicare bill again when Members return.
Supplemental Spending Bill:
Last night the Senate overwhelmingly approved a compromise war supplemental spending bill, which includes moratoria on six (of seven) pending and controversial Medicaid regulations. In May, the House and Senate had approved versions of the massive spending bill which included delays to all seven of the Medicaid regulations. But, due to a Presidential veto threat, House leaders entered into negotiations with the White House and Republican leaders. A compromise bill, which included six of the seven moratoria, was approved by the House on June 19th and the Senate last night. The six regulations delayed until April, 2009 include the Medicaid rehabilitative services option, targeted case management, and school-based services rules. The President is expected to sign the $257 billion legislation prior to expiration of the current moratoria on the rehab and school-based services rules on July 1st.
Labor-HHS-Education Appropriations:
The Senate Appropriations Committee approved its Labor-Health and Human Services (HHS)-Education spending bill yesterday – the largest spending bill of the 12 bills at $631 billion for fiscal year (FY) 2009. The bill contains $153.1 billion in discretionary spending, almost $7.7 billion more than President Bush requested for the agencies, and therefore faces a veto threat. Under the Senate bill, the Labor Department would receive approximately $12.3 billion, the Department of Health and Human Services would receive approximately $68.3 billion, and Department of Education would receive about $61.8 billion in FY 2009. Senators also adopted an amendment to the spending bill that would prevent implementation of a controversial August 17th directive to states placing new requirements on the State Children’s Health Insurance Program (SCHIP).
The House Labor-HHS-Education Appropriations Subcommittee approved its bill as well last week, however, a major disagreement between several Committee Democrats and Republicans cut the full Committee mark-up short on Thursday. As a result, the fate of the House spending bill remains unclear. Regardless, if this year’s Appropriations process does not end in a permanent Continuing Resolution (CR), it is likely that the Labor-HHS-Education spending bill will be incorporated into a larger, omnibus spending bill at the end of the year.
The July 4th recess began today (Friday) and we can expect a quiet week on Capitol Hill. We will keep you updated as developments on the Appropriations and Medicare bills occur.
