Bipartisan compromises on Medicare and Medicaid breathed new life into moribund balanced-budget talks last week, although provider groups said it may not be enough to break the stalemate between congressional Republicans and the Clinton administration.
Republicans and conservative Democrats were trying to sell members on a Medicare-reform measure that would squeeze $45.5 billion from hospital payments over seven years.
Meanwhile, data showing that the Medicare Hospital Insurance Trust Fund lost money last year for the first time since 1972-two years earlier than its board of trustees had projected-spurred renewed calls for the Clinton administration and House GOP leaders to resume negotiations on a seven-year balanced-budget deal.
That data, combined with the bipartisan Medicare proposal in the House and the state governors' support of a compromise Medicaid-reform plan, increases the odds that a new balanced-budget bill could be enacted this year.
Provider group representatives were quick to add, however, that it was unclear how much momentum the balanced-budget talks gained.
Richard Pollack, executive vice president of federal relations with the American Hospital Association, described last week's developments as "a lot of bobbing and weaving."
"I don't know what's out there now is enough pressure to get people back to the table," Pollack said.
Talks between Rep. William Thomas (R-Calif.), chairman of the House Ways and Means Committee's health subcommittee, and a group of conservative Democrats known as the "Blue Dogs" have yielded a draft Medicare reform proposal that would reduce Medicare spending by $168 billion over seven years when compared with current law.
That bill, which could be released early this week, would include House-passed language allowing provider networks to serve Medicare beneficiaries as managed-care organizations.
That bill would call for initial federal oversight and licensure of so-called provider-sponsored networks, a provision that providers have sought because they believe state insurance regulators treat such networks unfairly.
Rep. Collin Peterson (D-Minn.), the conservative Democrats' chief negotiator, said he and Thomas are in agreement on the proposal. He said they hope to attach the governors' Medicaid proposal to their Medicare compromise.