The Republicans' $350 billion Medicare provider payment and prescription-drug benefit bill passed the House early this morning on a 221-208 vote, with eight Democrats voting for the bill and about an equal number of Republicans opposing it.
The Democratic-led Senate is expected to take up a Medicare prescription-drug bill later this month. While a Medicare prescription-drug benefit may not pass this year, lobbyists said provider payment changes are certain.
House Republican leadership lobbied all week to win over reluctant members and pass the bill before leaving for a 10-day recess today. Among lawmakers, the central issue proved to be the relatively small portion of the bill affecting provider payments -- about $30 billion -- rather than the much larger Medicare drug benefit.
Rep. Marge Roukema (R-N.J.) was one of two Republicans who abstained from voting after her delegation failed to win a geographical reclassification that would have resulted in higher Medicare payments for New Jersey hospitals.
The American Hospital Association estimated that hospitals would gain about $14 billion over 10 years in additional Medicare payments under the bill. That includes nearly $2 billion over 10 years for an increase in Medicaid disproportionate-share payments, added to the bill yesterday. A Republican House staffer estimated that hospitals would end up with a net gain of at least $10 billion over 10 years under the bill.
Yesterday, lawmakers resolved differences between plans passed separately by the House Ways and Means and Energy and Commerce committees. Among the changes: a $40 home health copayment in the Ways and Means bill was eliminated and Medicare beneficiaries' annual out-of-pocket spending on prescriptions was capped at $3,700, instead of $3,800.