Health Policy Week In Review: The White House Touts Medicare Rebate Checks And Senate Dems Struggle To Advance Jobs Bill

Prominent among this week’s health policy headlines were the continuing reports about the Obama administration’s efforts to gin up public support for the new health reform law.

On Monday, for instance, Politico reported that the White House is launching a $125 million campaign likely to be co-chaired by former Senate Majority Leader Tom Daschle and Victoria Kennedy, the widow of Sen. Edward Kennedy. The campaign would explain, defend and depoliticize “health care reform now that people are starting to feel the new law’s effects.” Politico described the campaign as “extraordinary” and noted that it “could provide an unprecedented amount of cover” as the White House moves forward in the policy debate and Democrats struggle “to get political traction on the issue” (Allen, 6/7).

According to The New York Times, as part of the administration’s effort, President Barack Obama Tuesday conducted a “nationally televised question-and-answer session with older citizens to trumpet one of the law’s most popular features: $250 rebate checks to help Medicare beneficiaries pay for prescription drugs.” The event, which came just before the first batch of checks were mailed, will be “only an early hint of what is to come throughout the summer and fall, officials say, as other consumer-friendly provisions – a high-risk pool for hard-to-insure people, a Web site comparing coverage plans, tough new restrictions on insurers – take effect.” But with “Republicans campaigning on a theme of ‘repeal and replace’ and casting the law as big government – and some Democrats trying to avoid talking about it – the strategy poses some political risks” (Stolberg, 6/6).

The Associated Press recounted some of the questions posed to the president as an indication “that plenty of doubts remain even now that the rancorous health care debate has faded from the headlines” (Werner and Pace, 6/8). And even as Obama touted the Medicare rebate as a tangible benefit of reform, The Wall Street Journal noted the Republican counter message: “Despite the rebate checks, most seniors will see fewer benefits and higher health costs under the new law.” They point to cuts in the privately run Medicare Advantage plans as exhibit A (Adamy, 6/9). And the Los Angeles Times reported on criticism from House Minority Leader John Boehner, R-Ohio, who tagged the effort as “another in a long line of false starts and mishaps for the Obama administration’s attempt to sell its government takeover of healthcare.” Nonetheless, the president cautioned seniors “that repealing the law, as some Republicans are proposing, would have serious consequences (Levey, 6/9).

Meanwhile, Politico, in a separate story, explained why the sales pitch is so important. “There is widespread agreement that seniors are a crucial bloc to win on health reform. They’ve remained skeptical through the debate and typically vote in high numbers, particularly in midterm elections. So Democrats and Republicans alike have focused intensely on the group, vying to frame health reform as either an extension of Social Security’s safety net or a government takeover poised to ration benefits (Kliff, 6/8). According to Reuters, Democrats will drive home their point with “a 60-second television ad highlighting Republican vows to repeal the healthcare reform bill, which promises to be a flashpoint in the November election battle for control of Congress” (6/10).  

In other news, Senate Democrats continued to pursue the 60 votes necessary to clear their version of the pending jobs bill, which includes the Medicare doctor pay fix. The upper chamber completed work for the week without voting despite several days of tough negotiations. As part of the effort, they restored “an estimated $24 billion in Medicaid funds – dropped by the House before Memorial Day – after an outcry from governors and liberals,” according to Politico.” This step “promises to have broad bipartisan support – in statehouses, at least. In writing their 2011 budgets, as many as 30 governors had assumed that the assistance would continue through next June, forestalling deeper spending cuts at the state level” (Rogers, 6/8).

The New York Times reported on what could happen if Congress doesn’t extend these Medicaid funds. “Governors and state lawmakers, already facing some of the toughest budgets since the Great Depression, said the repercussions would extend far beyond health care, forcing them to make deep cuts to education, social services and public safety (Sack, 6/7).  

But voter concern and even anger about the federal deficit continues to intensify and hold a prominent place in many lawmakers’ minds — creating what the Los Angeles Times described as a “painful tradeoff” that will play out “when the Senate tries again to pass an extension of unemployment benefits – this time a $54-billion measure that marks an abrupt retreat from a $200-billion bill that Democratic leaders had proposed before the Memorial Day recess” (Hook, 6/7). Congress Daily points out some other critical unfinished business that is included in this legislative package. “Of paramount interest is Medicare physicians’ payments, which underwent a 21 percent cut on June 1 after the extenders bill went untouched in the Senate. … The Centers for Medicare and Medicaid Services placed a temporary freeze on all payments to physicians in anticipation of congressional action, but the stop-payment is expected to end next week” (Cohn and McCarthy, 6/7).

By mid-week, according to a separate story in The New York Times, Democrats were saying they expect to “ultimately pass the measure” and were “looking for lobbying help from governors who supported the inclusion of $24 billion sought by states for help with health care costs – one element of the Senate bill that drove the cost higher than the price tag in the House” (Hulse, 6/9). Such differences, said Politico, also in an additional story, “mean the unwieldy package will have to go back to the House, which only narrowly passed its version before Memorial Day” (Rogers, 6/8).

And to add an additional layer of complication to the scenario, Dow Jones Newswires/The Wall Street Journal reported Friday that some Senate Democrats are fighting to reinsert money to help laid-off workers afford to keep their former employers’ health coverage through the federal program known as COBRA. A similar provision was “stripped out in the House because of concerns of moderate Democrats about the cost of the bill.” Sen. Bob Casey, D-Pa., introduced an amendment that would extend the subsidy to people laid off through November, potentially at a cost of $7 billion for an estimated 144,000 people a month. “But despite the support of the three senior Senate Democrats – Majority Leader Harry Reid (D., Nev.), and his top lieutenants Sens. Richard Durbin (D., Ill.) and Charles Schumer (D., N.Y.), it is unclear whether the matter will come up for a vote on the Senate floor next week” (Boles and Raice, 6/10).