RECENT LEGISLATIVE activity on healthcare issues in Washington has focused heavily on oversight and disagreement over spending. It’s hard to say which came first.
President Bush’s $2.9 trillion fiscal year 2008 budget proposal, released Feb. 4, calls for $70 billion in cuts to Medicare and Medicaid over five years.
According to HHS Secretary Michael Leavitt, the president’s budget “reflects fiscally responsible steps to reform and modernize the Medicare program.”
Many members of Congress, trade associations and stakeholders disagree.
The American Hospital Association, for one, is strongly opposed to the Bush proposal. “Indiscriminate ratcheting of reimbursement for caregivers on the frontlines who provide needed services does nothing to address the underlying challenges,” wrote Rick Pollack, executive vice president of the AHA, in a Jan. 30 letter to Congress.
Democrats, who slated healthcare coverage for the poor and children at the top of their agenda this year, are up in arms not only over
proposed cuts to Medicare and Medicaid, but over what they see as a direct attack on the State Children’s Health Insurance Program.
Bush has proposed a $675 million increase to SCHIP funding, to total $5 billion in fiscal 2008. Democrats argue this proposal falls at least $12 billion short of fully funding the program. Federal matching for SCHIP funds would be greatly reduced, encouraging states to cut back on coverage for lower-income families, opponents of the Bush plan say.
Rep. Pete Stark (D-Calif.), chairman of the House Ways and Means Health subcommittee, said beneficiaries of U.S. entitlement programs could suffer, and “the President’s divisive budget is an exercise in make-believe intended to incite partisanship, not invite policymaking.”
Opposition to Bush’s plan has only seemed to fuel the fire of an already blazing Congressional desire to increase oversight across all federally funded healthcare activity. With battle lines drawn, Democrats are wielding the sword of oversight without hesitation. It appears that if the president is not willing to bend on his budget, then Congress will look under every rock it can for the funding it seeks for entitlement programs.
Congressional hearings crop up almost daily. Rep. Henry Waxman (D-Calif.), chairman of the House Oversight and Government Reform Committee, for example, plans to get to the bottom of drug pricing. On Feb. 9, he called for the chief executives of 12 Medicare insurers to produce their Part D prescription drug pricing information, including profits and administrative costs associated with Medicare Part D coverage. Oversight hearings will follow.
The Centers for Medicare & Medicaid Services took some heat on Feb. 8 when Sens. Max Baucus (D-Mont.) and Chuck Grassley (R-Iowa) and Stark called for increased federal oversight of physician-owned specialty hospitals following the death of a patient in Texas who had received allegedly inadequate emergency care.
Sen. Herb Kohl (D-Wisc.), chairman of the Special Committee on Aging, has asked CMS to come up with a comprehensive plan for fixing the hole in Medicare Part D coverage, to be presented in upcoming hearings.