Democrats: Medicare physician pay cuts could hurt Tricare

By Anna Edney CongressDaily July 9, 2008 UPDATE: With ailing Senate Health, Education, Labor and Pensions Chairman Edward Kennedy, D-Mass., making a dramatic return to provide the deciding vote, the Senate Wednesday afternoon invoked cloture, 69-30, on the bill to block a cut in Medicare payments to physicians.

Leading up to Wednesday's Medicare cloture vote, Senate Democrats Tuesday shot down the idea of changing the bill to entice Republicans and intensified pressure on the GOP opposition.

Instead, they reminded members every chance they could that Medicare physician payment cuts will not just jeopardize seniors' health care, but that of the nation's troops and veterans.

Military and physicians' groups routinely note that soldiers' health care also hinges on stopping the 10.6 percent payment cut to physicians' Medicare reimbursement rates.

But lawmakers had not given the issue much play until this week. Reimbursement rates for the military's health system, Tricare, are linked to Medicare rates.

Senate Majority Whip Richard Durbin, D-Ill., led the way over the weekend, bringing up military health care during Saturday's Democratic radio address. Other senators followed suit Tuesday.

"Further delay could endanger health care for military retirees and even for those on active duty," Senate Finance Committee Chairman Max Baucus, D-Mont., said at a Tuesday briefing. Sen. Blanche Lincoln, D-Ark., chimed in, evoking military families that depend on Tricare.

"Their families' abilities to access the health care that they need is critical," Lincoln said.

A spokeswoman for Baucus said such comments were not a ploy for votes. "I think as the cut takes effect, its implications across the board - including this one outside Medicare - are becoming more apparent."

Senate Majority Leader Harry Reid, D-Nev., echoed the Tricare concerns later in the day. "This affects not only seniors but Tricare - veterans, people in the military."

Some Republicans hoped Democrats would slip GOP pet projects into the bill in exchange for votes, but Reid made no concessions. He said he does not plan to allow debate on any amendments if cloture is achieved. "They've had weeks and months," Reid said.

Democrats instead will rely on mounting pressure from military and physicians' groups now that the July 1 deadline for the cut has passed to persuade the GOP to support limiting debate on the Medicare bill this time around.

"[If] we don't get 60 votes, the Republicans are going to have to live with that," Reid said.

The Military Officers Association of America did its part Tuesday to make Republicans squirm. MOAA sent a special alert to its members asking them to e-mail senators, said retired Col. Steve Stobridge, the group's director of government relations. Within just a few hours, 14,000 MOAA member e-mails filled Capitol Hill in-boxes.

While the Centers for Medicare and Medicaid Services delayed processing claims through mid-July to buy Congress time, Stobridge said the Defense Department gave Tricare more wiggle room.

By law, Tricare payment rates are linked to Medicare rates, but the military program has the flexibility to implement the rates at a later date, Stobridge said. The Pentagon did not specify a date the cut must take effect, but said it would hold out at least through later in the summer, he said.

The cloture vote Wednesday is the second in as many weeks. Senate Democrats fell one vote short June 26 of limiting debate. Republican leadership continued Tuesday to push a short-term extension of expiring Medicare programs to allow more time to negotiate, but Democrats rejected the idea. Republicans generally have opposed paying for the legislation by cutting extra payments to private insurers that offer Medicare Advantage plans.

"Your suggestion of a 31-day extension is as disingenuous as it is ineffective. It will only offer patients and doctors uncertainty and administrative headaches," Reid wrote Republican leaders Tuesday.

The House passed the Medicare bill by a 355-59 margin on June 24.