On the eve of a showdown vote on overhauling Medicare, House Republicans sweetened the pot Wednesday for rural health providers, eased cuts for hospitals with foreign doctors and discarded a break for chiropractors.
House Speaker Newt Gingrich grumbled that some Republicans were engaging in “Christmas shopping” by demanding changes in exchange for their votes. About 30 Republicans were still “wrestling” with their decisions, the speaker said, but he predicted, “My guess is we are going to win.”
At the White House, spokesman Mike McCurry said, “They’re scrambling to try to fix the mess that they’ve created.”
Nonetheless, the stage was set for a day of floor debate today with a vote by evening on the GOP blueprint for squeezing $270 billion from Medicare. The program would be put on strict new spending limits and opened to competition from private managed care and other health plans.
The 37 million elderly or disabled Medicare beneficiaries could keep their current government coverage, jump to new “MedicarePlus” plans or opt for medical savings accounts combined with catastrophic-only insurance.
Most of the $270 billion in Medicare savings would come from ratcheting down fee increases for hospitals, physicians, home health agencies and other providers.
Medicare beneficiaries would pay higher monthly premiums, with the charge for their Part B coverage climbing from $46.10 now to $53.40 in January 1996 and to $88.20 by January 2002. Wealthier retirees would face even higher premiums.
“For the first time in 30 years, we are talking about major transformation of Medicare instead of just how we cut around the edges,” said Rep. Bill Archer, chairman of the House Ways and Means Committee.
But Rep. Sam Gibbons, D-Fla., said Republicans were mounting a “stealth attack on the American people. … You can’t see it, you can’t hear it until you’re dead.”
At nightfall, Democrats rallied on the steps of the Capitol to denounce the planned GOP transformation of Medicare. House Minority Leader Dick Gephardt called it “a very dark hour in the history of American health care” and predicted that over the next seven years, “25 percent of the hospitals and health care facilities in this country will close.”
Archer, R-Texas, said rural health plans will now be guaranteed a minimum payment of $250 a month for each senior citizen they sign up for “MedicarePlus.”
Under the original formula, the payments would have been $200 or less in some counties. The payments range as high as $600 to $700 a month in big cities with the steepest medical costs, such as Miami and New York.
The extra money for rural health plans would come from shaving the increases for health maintenance organizations and other plans in larger counties.
Rep. Doug Bereuter, R-Neb., said the formula was still “brutally inequitable.” He said that “somewhere over 20” rural GOP lawmakers were still withholding support for the bill - enough to block it.