Democratic Health Care Agenda Faces Obstacles Next Year

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Democratic Health Care Agenda Faces Obstacles Next Year [Dec 18, 2006] Democrats next year likely will seek to pass legislation that would require CMS to negotiate directly with pharmaceutical companies on prices for medications under the Medicare prescription drug benefit, but approval of such legislation will require them to "win over some Republicans and one of their own," the Albany Times Union reports. Such legislation would require 60 votes, nine more than the Democratic majority, to ensure passage in the Senate, and incoming Senate Finance Committee Chair Max Baucus (D-Mont.) has voted against similar legislation three times, according to the Times Union (Dlouhy, Albany Times Union, 12/17). In addition, a promise to "be more fiscally responsible than their Republican predecessors" might limit the ability of Democrats to pass legislation that would eliminate the Medicare prescription drug benefit "doughnut hole," a proposal that would cost an estimated $5 billion annually, the Christian Science Monitor reports. Under the doughnut hole, Medicare beneficiaries are responsible for 100% of annual prescription drug costs between $2,250 and $5,100. According to incoming House Speaker Pelosi (D-Calif.), Democrats plans enforce pay-as-you-go rules that require lawmakers to offset proposals that would increase federal spending with tax increases or spending reductions in other areas. Bob Bixby -- director of the Concord Coalition, a budget watchdog group -- said, "If you do make the prescription drug benefit more generous, that could get very, very expensive, and there's no obvious way to pay for that" (Grier, Christian Science Monitor, 12/14). Union Might Benefit The Democratic takeover of Congress next year is likely to improve the ability of the American Federation of Government Employees, which represents about 700,000 federal employees, to negotiate on health benefits and other issues, the Washington Post reports. Incoming House Majority Leader Steny Hoyer (D-Md.) said that he plans to work to limit increases in health insurance premiums and ensure wage increases for federal employees and try to create a "more cooperative relationship with the White House." Beth Moten, legislative and political director for AFGE, said, "We expect the Democratic Congress to support the federal employees with regard to wages, health insurance and retirement." AFGE President Gage said that under the Bush administration, the ability of the union to "sit down with the agencies and work out problems and differences has really declined" (Goldfarb, Washington Post, 12/18). Appropriations Bills In related news, Democrats last week announced plans to seek a continuing resolution to fund most federal agencies at fiscal year 2006 levels until Sept. 30, 2007, the Washington Post reports. Congress this year approved only two of 11 FY 2007 appropriations bills and passed a CR to fund most federal agencies until February 2007. According to the Post, "Democrats will make some adjustments" in a new CR, "especially in the Department of Veterans Affairs health care system, which needs $3 billion more just to keep covering all the veterans it covers now." Incoming House Appropriations Committee Chair Obey (D-Wis.) said, "We did not call the shots here. We will try to provide modest adjustments where we can, but a lot of people will be left short" (Weisman/Montgomery, Washington Post, 12/17). Hastert Medicare Advantage Provision In other congressional news, the Post on Saturday examined reaction to a Medicare Advantage provision that outgoing House Speaker Dennis Hastert (R-Ill.) "quietly inserted" in a tax, trade and health care bill approved earlier this month (Birnbaum, Washington Post, 12/16). The provision suspends enrollment deadlines for certain Medicare Advantage plans -- which include those operated by Illinois-based Aon; Sterling Life Insurance Company, an Aon subsidiary; and potentially other insurers. The provision allows beneficiaries to enroll in the Medicare Advantage plans at any time during the year, rather than from Nov. 15 through Dec. 31 (Kaiser Daily Health Policy Report, 12/15). Baucus said that the provision "creates an unlevel playing field" for Medicare Advantage plans. Outgoing Senate Finance Committee Chair Chuck Grassley (R-Iowa) said that he was "disappointed in the process that led to the provision being included in the bill." Baucus, Grassley and incoming Senate Minority Leader Mitch McConnell (R-Ky.) said that they might seek to eliminate the provision from the bill after Congress reconvenes next year (Washington Post, 12/16). Editorials

Atlanta Journal-Constitution: Hastert "thumbed his nose at American voters and fellow lawmakers by sneaking a last-minute amendment through Congress aimed at benefiting a big insurance company in his home state," a Journal-Constitution editorial states. "He should be ashamed -- but he probably isn't," the editorial concludes (Atlanta Journal-Constitution, 12/18).

New York Times: "The incoming Democratic chairmen of Congress' appropriations committees announced last week that a big chunk of the federal government will operate next year under 2006 budgets," a Times editorial states, adding that this decision "will allow the new Congress to focus on programs where the needs are great -- and rising -- like veterans' health care and low-income housing." The editorial states that President Bush "is to blame" for the failure of Congress to approve nine of 11 FY 2007 appropriations bills and that Bush next year must "step up ... to ask for more money as needed" (New York Times, 12/18).

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