Medicare Cuts in House Health Reform Bill Politically Unrealistic

The health care reform bill (HR 3962) that passed in the U.S. House of Representatives by the slimmest of margins last week was dealt a serious setback this weekend when the Centers for Medicare and Medicaid Services (CMS) released a new study that, according to the Washington Post, “found Medicare cuts contained in the health package approved by the House on Nov. 7 are likely to prove so costly to hospitals and nursing homes that they could stop taking Medicare altogether.”

The lede of the Post story, entitled, “Report: Bill Would Reduce Senior Care” is brutal:

A plan to slash more than $500 billion from future Medicare spending — one of the biggest sources of funding for President Obama’s proposed overhaul of the nation’s health-care system — would sharply reduce benefits for some senior citizens and could jeopardize access to care for millions of others, according to a government evaluation released Saturday.

Following the taxpayer-funded abortion controversy surrounding the Stupak amendment, and the Democratic leadership’s need to retreat in order to pick up moderate Blue Dog support, the CMS study has enormous implications in terms of how a final bill will be shaped in Conference once a Senate bill clears the floor.

The fact the Post reported the House bill “would sharply reduce benefits for some senior citizens and could jeopardize access to care for millions of others,” has provided the GOP with yet another weapon to hammer marginal House and Senate Democrats, and another reason to vote against or be extremely leery of a final bill that slashes seniors’ benefits.

The CMS study is somewhat helpful to the Skilled Nursing Facility (SNF) sector’s effort to help ensure the $23.9 billion, ten year cuts contained in HR 3962 to help finance the package could be pushed downward more in line with the existing Senate Finance Committee package crafted by Sen. Max Baucus (D-MT).

Interestingly, in regard to the whole notion of “cuts” to Medicare needed to finance any final reform bill, Sen. Kent Conrad (D-ND) engages in a bit of selective memory by stating, “I think we’ve got to be very careful about our language. There are no cuts in any of these bills. There are reductions in the increases that they’re scheduled to receive” (“State of the Union,” CNN, 11/15).

In 1996, when Republicans sought to trim the growth in Medicare spending, much like what is being attempted now by the Democrats, GOP Senate and House candidates — as well as presidential nominee Bob Dole — were skewered for “cutting” Medicare. Besides the burden of defending the steep costs of a health care bill, House and Senate leaders will inevitably be forced to deal with the political implications of cutting Medicare spending — or, more accurately, trimming the growth of the program. This will become a more significant issue once a bill, presumably, makes it to Conference. The bottom line it very unlikely the high level of Medicare spending reductions providers now face in the House bill will survive.

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