11-01-2000

POLITICS & POLICY - MEDICARE 'GIVEBACKS': CLINTON ESCALATES FIGHT WITH GOP

 
      President Clinton yesterday "escalated" the battle over a
 Medicare 'giveback' measure, which would return $30 billion to
 Medicare providers and HMOs over five years, demanding that
 Congress allocate more funding for health programs for low-income
 Americans, disabled children and legal immigrants and less for
 private health plans, the New York Times reports.  The fight over
 the legislation, part of a $240 billion, 10-year tax cut bill,
 jeopardizes the expected increase in payments to health care
 providers.  "We are not rejecting all HMO payment increases.  The
 president simply wants more accountability and a more equitable
 distribution of resources to beneficiaries and health care
 providers," Chris Jennings, White House health policy
 coordinator, said.  While Clinton has called the provision "an
 unjustifiable spending increase for HMOs," most Republicans and
 some Democrats argue that the increased funding will help prevent
 "wholesale defections" of HMOs from the Medicare program.  "The
 president sees imperfections in this bill for political reasons,"
 Rep. Bill Thomas (R-Calif.) said, adding, "This measure is done. 
 All the president has to do is sign it."  Collin Peterson
 (D-Minn.) warned that if the president failed to pass the current
 version of the bill, "I'm not sure you'll get another bill. 
 We'll be a long way into next year before we get more money out
 to hospitals, nursing homes and home health agencies."  The
 health care industry "strongly supports" the Medicare
 legislation, and the possibility of delay has "alarmed
 hospitals," which say they need immediate financial aid.  "There
 has been an assumption all year ... that Congress would fix the
 Balanced Budget Act.  But if Congress goes into a lame duck
 session, there's no certainty," Thomas Scully, president of the
 Federation for American Hospitals, said.
      DEBATE 'CRYSTALLIZES' CLINTON-HMO FEUD
      Although 16% of Medicare recipients have enrolled in HMOs,
 the White House contends that private health plans would receive
 34% of the funds provided by the Medicare bill.  With his term
 drawing to a close, Clinton has tried to "force" Congress to
 "accept his priorities" on the legislation, insisting that
 lawmakers allow Medicaid coverage for pregnant women and children
 who are legal immigrants, permit working parents to purchase
 Medicaid coverage for children with disabilities and "make it
 easier" for children to enroll in Medicaid.  The "dispute" over
 Medicare payments also "crystallizes" a long-standing feud
 between the administration and HMOs, which have "blocked"
 bipartisan patients' rights efforts.  According to health plan
 officials, however, Clinton has "little comprehension of how
 health care markets work."  They warn that his attempts to lock
 HMOs into Medicare with three-year contracts would drive them out
 of the program.  "No responsible party ... would be locked into
 Medicare for three years, with no concept of how much they would
 be paid by the government in the second or third year," Diana
 Dennett, executive vice president of the American Association of
 Health Plans, said.  Republicans have also urged Clinton to sign
 the Medicare legislation because the provision also would provide
 new benefits to recipients -- such as expanded coverage for
 mammograms, Pap smears and pelvic exams, wider coverage for colon
 cancer screening, funding for eye exams to detect glaucoma and
 less expensive outpatient hospital care (Pear, New York Times,
 11/1).
 



American Healthline