Health reform deals in doubt
Senate may undo earlier agreements
WASHINGTON – Heading into a make-or-break week, Senate Democratic leaders are struggling to preserve the fragile support of interest groups for a sweeping overhaul of the nation’s health care system, even as lawmakers seek to change the carefully crafted provisions that brought the groups on board.
On the floor and behind closed doors, the Senate wrestled Saturday with amendments that would impose additional cost-control requirements on hospitals, doctors and drug companies, squeezing out savings beyond the considerable sums those groups already had volunteered to give up.
Of particular concern to seniors groups is an effort by many lawmakers to strengthen a new independent board that would determine the future of Medicare, raising the possibility of cuts deeper than those envisioned in the $848 billion health care bill.
But other unresolved issues that have attracted less public attention pose a direct threat to deals cut by the White House months ago to appease the American Hospital Association, the Pharmaceutical Research and Manufacturers of America and other industry groups whose opposition proved lethal to President Bill Clinton’s 1994 quest for reform.
Although those agreements helped to clear a political path for reform to move forward, many Democrats have criticized them as overly generous.
Hospital groups, for example, are quietly steaming over a measure unveiled Friday by Sens. Joseph Lieberman, I-Conn., Arlen Specter, D-Pa., and Susan Collins, R-Maine, aimed at improving quality and lowering costs throughout the health care system. One provision would impose stiff penalties on hospitals with high infection rates – a top priority for Collins, who is being wooed by Majority Leader Harry Reid as a potential GOP convert.
Another pending amendment causing heartburn for Reid is a proposal by Sen. Byron Dorgan, D-N.D., that would permit U.S. pharmacies and drug wholesalers to import lower-priced medications from other countries, including Canada. Drug reimportation is a popular bipartisan cause on Capitol Hill.
A preliminary estimate by the nonpartisan Congressional Budget Office shows that the Dorgan amendment would save the government about $19 billion over 10 years.
The drug industry would suffer another costly blow under an amendment by Sen. Bill Nelson, D-Fla., that would transfer about 6 million seniors eligible for Medicare into the Medicaid program, which pays much lower prices for the same drugs. Under Nelson’s amendment, half the $106 billion in savings would be used to close the coverage gap in the Medicare prescription drug program known as the “doughnut hole.”
Closing the hole is the top priority of the AARP, which has sent signals that it could turn against the Senate bill unless Nelson’s effort succeeds.