"Congress made the right choice this morning for patients and communities by voting to halt damaging cuts to hospitals that care for low-income working families and others who face financial challenges," said Dr. Bruce Siegel, CEO of America's Essential Hospitals, which represents the nation's safety-net facilities.
The Senate incorporated the House bill's own surprises like the Chronic Care Act, which opens up new flexibilities for Medicare Advantage and care for chronically ill Medicare beneficiaries, and a provision to slow implementation of the Merit-based Incentive Payment System that makes providers accountable for Medicare savings.
But then it went much further. Some additions hadn't been expected at all. The Medicare Part D donut hole provision, for example—which increases the discount drug manufacturers have to give beneficiaries from 50% to 70%—caught even House Energy and Commerce Committee Chairman Greg Walden (R-Ore.) off guard.
Walden told reporters that he didn't know about the measure until the Senate released it, and that he wants his committee to take a look at its impact.
"I support the overall package," Walden said. "I'd have written it differently, because I think there are some public policy issues that we'll probably have to address later on because they could have an effect of actually raising list prices (for drugs). We would have to study the impact, but this was something that to my understanding came in from the Senate side, so we were not, how shall I say it diplomatically, consulted much."
Its inclusion may spur a legislative fight and immediately roused the ire of the Pharmaceutical Research and Manufacturers of America, which called it a bailout of insurance companies.