PAYMENT: Congress Likely To Block Bush Cuts — Can Bush Block Medicare Advantage Cuts?
February 2nd, 2007
by
Chris Fleming
|
President Bush’s fiscal year 2008 budget will propose cutting Medicare and Medicaid by $70 billion over five years, Robert Pear reports in the New York Times. The administration is expected to propose freezing Medicare payments to home health agencies and reducing payment updates for hospitals, nursing homes, and other providers. The Bush budget also assumes that Medicare physician reimbursement will receive an 8 percent cut next year.
In addition to all of this, the president is expected to propose changes to the State Children’s Health Insurance Program (SCHIP) that would reduce payments to states that cover children in families with incomes over twice the poverty level. (Stay tuned for Health Affairs’ upcoming March/April issue, which will focus on SCHIP and other children’s health issues.) The one item left untouched in the Bush budget is Medicare payments to the program’s private plans, despite widespread criticism of perceived overpayments to those plans.
The vast majority of the administration’s proposed cutbacks are unlikely to get through the Democratic-controlled Congress. However, some assume that the White House’s rejection of Medicare Advantage cuts will stand, since those cuts would require new legislation that could be vetoed by President Bush. In his blog, Robert Laszewski says this “laughable contention” ignores the way year-end omnibus spending bills take shape.
Laszewski notes the power that Democratic committee chairmen (including “some very liberal Medicare Advantage haters”) will have to determine what’s in a year-end budget bill. “There were many things in last December’s [Republican-crafted omnibus] bill that never passed either house of Congress — like the health savings account (HSA) enhancements that became law in this bill,” he writes. “My point is that if the Dems want to cut Medicare Advantage ‘over payments’ — and they do — they can get them in the final ‘omnibus’ package.”
If Democrats present Bush with a budget bill containing Medicare Advantage cuts -– likely accompanied by some goodies that Bush wants — would Bush risk a government shutdown by vetoing the whole final budget bill to protect Medicare Advantage payments? “Dream on” is Laszweski’s answer.
