Congress has adjourned without taking action on provider payment relief or Medicare prescription drug coverage, leaving a lame-duck session as the last chance to advance legislation before the election shuffles the makeup of Congress. Some lobbying groups, including the American Medical Association and the AARP, are waging major campaigns over the next few weeks to spur action when the current Congress returns on Nov. 12, one week after the midterm election.
On Wednesday, senators pushing a $43 billion provider relief package once again attempted to bring the bill to the Senate floor for consideration. And, for a second time, they were rebuffed by Sen. Don Nickles (R-Okla.), who objects to the bill moving forward without having been vetted in the Senate Finance Committee.
This summer, the House of Representatives passed a prescription drug bill that included $30 billion in provider payment relief.
Lobbyists are still hopeful next month's lame duck session will provide an opportunity to revive the controversial Senate bill. Some pointed to the Benefits Improvement and Protection Act of 2000, which rolled back cuts enacted by the Balanced Budget Act of 1997 but wasn't passed until late in the legislative session.
Despite a range of obstacles -- including President Bush's opposition to the Senate bill -- provider relief "can still be done," one hospital lobbyist said. The bill would reverse cuts that took effect Oct. 1 for home health, indirect medical education and disproportionate-share payments, as well as offer some help to Medicare HMOs. It would also include an inpatient update and a boost in physician payments.
Earlier this week, the AMA stepped up its lobbying effort to have Congress fix the physician payment formula, which the group said will result in beneficiaries losing access to care if it is not changed to reflect economic realities.
The AARP yesterday also moved to increase its visibility on prescription drugs and Social Security as the midterm election nears. In what the AARP called "the most far reaching and most extensive voter education campaign" in the country, the powerful seniors lobby will spend $4 million on national television ads over the next few weeks to encourage seniors to vote with a knowledge of their candidates' position on prescription drugs.
AARP President Bill Novelli said a provider relief bill with no prescription drug coverage would "add to beneficiaries' out-of-pocket costs by financing another round of expensive givebacks." The stalled Senate bill does not include drug coverage under Medicare, and some lawmakers, such as Sen. Olympia Snowe (R-Maine), have said provider relief needs to also include a drug benefit for seniors.
One other option for hospital advocates is to persuade Congress to include provider relief in a "continuing resolution" that funds government programs in lieu of stalled appropriations bills. The AMA is considering that option, but the Bush administration may not be enthusiastic about big-ticket amendments to a temporary spending measure, sources said.