Both Sides Reviewing Medicare ‘Givebacks’ Compromise Agreement
Negotiators attempted on Dec. 12 to put the "finishing touches" on the "Medicare-Medicaid 'givebacks'" legislation, with Republicans "apparently add[ing] nearly $2 billion over five years to the package in an effort to win approval from Democrats," CongressDaily reports. The bill, which would restore billions in cuts from providers and managed care companies under the 1997 Balanced Budget Act, now awaits review from both sides before it can be finalized. Under the bill, rural home health agencies, rural hospitals and teaching hospitals would divide $1.5 billion in additional Medicare funds, and the 24-month waiting period for Medicare eligibility for those with Lou Gehrig's disease would be waived, as "[m]ost of those" disabled by the disease die within that time frame. Also, according to CongressDaily, the measure "apparently would extend for a year provisions allowing welfare families who leave the rolls for jobs to retain Medicaid coverage temporarily, and would allow schools and other entities to deem children presumptively eligible -- a process that reduces the enrollment burden -- for the Children's Health Insurance Program." Despite these additions, the Clinton administration "apparently did not get its top priorities," which include a "scaled-down version of the Family Opportunity Act (S 2274) that would allow moderate-income families to keep their disabled children enrolled in Medicaid" and language that would "restore Medicaid eligibility to legal immigrant pregnant women and children." It remains "unclear" whether the final legislation will include administration provisions to "encourage" HMOs to sign multi-year contracts; the White House had previously sought to require such agreements (Rovner, CongressDaily, 12/12).
Riding with Labor-HHS
CongressDaily also reports that the giveback legislation is now likely to be included as part of the $108.9 billion Labor-HHS appropriations bill, an addition that "should be enough to garner most members' support for the larger deal." Rep. Michael Castle (R-Del.) said, "Based on what I've heard and seen, the outlines of the agreement would appear to satisfy a majority of members and the president. It strikes a good balance." But Rep. Pat Toomey (R-Pa.) expressed continuing concern. "In a nutshell, I think we're spending too much money here," he said. An aide to another "conservative member" said, "Many conservatives will oppose it on policy and fiscal grounds," but the "Medicare givebacks will be a powerful incentive for many members" (Caruso, CongressDaily, 12/12).