Trying to seize the political high ground on Medicare, congressional Republicans pushed budget blueprints through the Senate and the House last week. The blueprints would set aside billions of federal surplus dollars to beef up Medicare.
The Republicans drafted the blueprints in a counterattack on President Clinton's call to put $700 billion of surplus funds into the Medicare Hospital Insurance Trust Fund over 15 years. The GOP plans would reserve surplus dollars to finance Medicare reform proposals such as the ones the National Bipartisan Commission on the Future of Medicare developed but didn't formally approve (See story below).
The GOP called its mechanism for saving those surplus funds generated by Medicare and Social Security payroll tax collections a "lockbox." The funds in the lockbox could be released only if a major Medicare reform package was passed.
Medicare reached a flash point last week, with Democrats maneuvering to try to pass Clinton's plan and Republicans criticizing Clinton. In dueling press conferences, both sides claimed their plans would do more to improve the health of the Medicare Hospital Insurance Trust Fund.
Republican leaders cited Clinton's proposal to reduce provider payments by $9 billion over five years-which the GOP did not endorse-and to earmark $700 billion in surplus funds without any restructuring.
"We're still scratching our heads on that one," said Rep. J.C. Watts (R-Okla.), chairman of the House GOP caucus. "How can you save Medicare and take $9 billion away from it?"
In a statement after the congressional votes, Clinton called the Republican budget "a series of missed opportunities."
"It fails to lock in debt reduction, fails to extend the solvency of Social Security and Medicare, and fails to protect key investments for the American people," Clinton said.
Republicans, meanwhile, said their plan to lock away $1.8 trillion in Social Security and Medicare surplus funds for those two programs actually would devote $100 billion more than Clinton's plan.
"That's rhetorical," said Rep. John Spratt Jr. (D-S.C.), senior Democrat on the House Budget Committee. Unlike Clinton's plan, the GOP blueprint "doesn't put any assets in the (Medicare) trust fund to meet obligations," he said.
Hospitals, however, supported the GOP lockbox idea.
"For the first time, it really links Medicare and Social Security," said Kristen Morris, director of legislative operations for the American Hospital Association.
"We're pleased that there is the recognition and the commitment by Republicans to set aside reserves for Medicare," she said. "From the perspective that we have a budget that does not cut (payments) . . . and also does say Medicare is Social Security, we really have to say that the Republican budget is the best alternative out there."
Before it passed the GOP plan by a 221-208 vote, the House rejected three Democratic plans, including Clinton's, one drafted by conservative Democrats and one drafted by Spratt.
The Senate voted 55-44 in favor of the Republican plan. Significantly, Sen. John Breaux (D-La.), who was chairman of the bipartisan Medicare commission, crossed party lines to vote with the GOP. The Senate budget blueprint included an amendment stating that Congress should debate the commission's Medicare reform proposal, which Breaux wrote.