Increasing Medicare and Medicaid payments to healthcare providers will be a must-do item for Congress in its final four-week push before adjournment, congressional aides said last week.
Speaking to reporters, Republican and Democratic aides from the House and Senate signaled that support was widespread enough in Congress that lawmakers are almost sure to follow up on last year's five-year, $16.1 billion package of rollbacks of Medicare and Medicaid payment constraints imposed under the Balanced Budget Act of 1997.
Enactment of such a package is more likely than passage of managed-care reforms or a prescription drug benefit for Medicare beneficiaries, both of which are higher-profile political issues but highly controversial, the aides said.
"I think the one thing that's a guarantee is a (balanced-budget law) relief package because everybody wants it, and they've been hearing from (constituents in) their districts," said a House GOP aide, who spoke on condition of anonymity.
But the aides wouldn't say how much Medicare payments would increase or how increases would be distributed among providers, nor would they say how soon a legislative proposal will be released.
Provider group lobbyists said they believe the first action on the legislation could take place as early as next week. Proposals may start surfacing this week.
Hospitals' chief goal is an update to Medicare inpatient payment rates equal to an inflation index called the hospital marketbasket. Such an update alone could increase Medicare spending by an additional $9.5 billion during the next five years.
Provider group lobbyists were heartened by news of payment increases but cautioned that the weeks before Congress' scheduled Oct. 6 adjournment will be politically divisive given the Nov. 7 elections.
Congressional support for Medicare payment increases could actually become a bill's worst enemy, said Thomas Scully, president and chief executive officer of the Federation of American Hospitals.
"I am optimistically scared to death," he said. "There's a lot of momentum, but there are a lot of ways it can go off-track. Everyone who wants to do tax cuts, everyone who wants to pass HMO reforms and everyone who wants to do a prescription drug benefit will be looking at slapping (Medicare) relief on it to give it momentum."