Republican leaders have stripped about $10 billion in hospital Medicare spending reductions over five years from a House budget proposal, but some $4.8 billion in Medicaid budget trims remain in the bill.
GOP leaders decided to eliminate the Medicare cuts after vigorous lobbying from hospital groups. The budget proposal, a nonbinding blueprint of House spending priorities, was passed by the House in a 216-204 vote late last week.
Although the spending reduction proposal had made it through at least one House committee, many observers had predicted its demise (June 1, p. 3).
The legislation called for reducing hospitals' Medicare reimbursement for capital costs by 25% over five years and eliminating Medicare compensation for beneficiaries' unpaid hospital bills.
The Medicaid savings would come from a lump-sum payment to states to cover beneficiaries' acute-care costs.
Hospital group lobbyists said they will try to get Senate and House leaders to nix the Medicaid cuts when they meet to resolve differences between their versions of the plan. The Senate plan doesn't include Medicare or Medicaid cuts.
Meanwhile, in a procedural vote, the House unanimously voted down user fees hospitals would have paid to HCFA. Those fees would have totaled $3.3 billion over five years. Because the vote was largely symbolic, the user-fee issue could come up for another vote.