Medicare bill nearly law but lobbies stay focused

Barring extraordinary turns by several Senate Republicans next week, the Medicare bill will end its nearly eight-month journey but some of the special interests working on the bill plan to keep up the pressure until the end.

America’s Health Insurance Plans (AHIP), which opposes the provision in the bill reducing spending on private Medicare Advantage plans, and the seniors’ lobby AARP, which supports the fix to physician payment cuts that make up the centerpiece of the legislation, have made clear that they were not taking their eyes off the ball.

{mosads}The AARP is taking nothing for granted. The group wrote President Bush asking him to reconsider his veto and directed more than 45,000 emails from members and supporters to the White House.

The group made clear that it will continue to lobby Capitol Hill as well, both to express gratitude to lawmakers who have already voted for the bill and to attempt to persuade opponents to support the veto override.

“We’re hoping for the best and preparing for everything else,” Nancy LeaMond, AARP's Executive Vice President of Social Impact, said. “We are not taking any signature or vote for granted. We’ve come too far in this campaign to let up at the end.”

The AARP’s endgame on Medicare will include ushering Medicare beneficiaries to lawmakers’ offices, organizing a grassroots letter-writing and telephone campaign and running advertisements in favor of the veto override.

Meanwhile, AHIP is not taking defeat for granted, either. The insurance industry lobby has hoped to sway lawmakers by cautioning them that many beneficiaries enrolled in Medicare Advantage, particularly those in so-called private fee-for-services plans, will be displeased if they cannot renew their plans in the future.

“It’s unfortunate that Congress chose to cut the Medicare Advantage program that so many seniors rely on,” AHIP President and CEO Karen Ignagni said. “Seniors enrolled in Medicare Advantage could face limited choices, reduced benefits, and higher out-of-pocket costs if these cuts became law.”

AHIP has been issuing press releases with projections of how many beneficiaries in certain states would no longer have access to the Medicare Advantage plans under the legislation. It targets states such as Georgia, Pennsylvania and Virginia that are home to Republican senators who originally opposed the bill but reversed their positions this week.

In the end, though, the campaigns by the AARP, AHIP and others may be moot.

The Senate approved the measure Wednesday on a 69-30 vote, winning support from two more senators than needed to override President Bush’s threatened veto. The House passed the bill 355 to 59 in June, also a large enough margin to meet the two-thirds majority required to rebuke the veto. House and Senate leaders are expected to hold votes as soon as possible after Bush sends the bill back to Congress.

In the House, that means 65 lawmakers who supported the bill would have to change their positions.

The main purpose of the bill is to undo a 10.6 percent cut in physician fees that kicked in July 1. The White House, the congressional Republican leadership and the health insurance industry oppose the bill because Democrats seek to reduce spending on Medicare Advantage plans by $14 billion over five years in order to pay for the expense of raising physician payments.

Though the margin is narrower in the Senate, three Republicans who had previously voted against the measure would have to switch their positions, which is an unlikely prospect despite whatever pressure the Senate GOP leadership might try to apply to them. Eight of those senators have unequivocally stated they would vote to override the veto. In addition, Sen. Kit Bond (R-Mo.) voted against the bill but later said he’d vote for an override.

Of the Republicans who changed their positions, only Sen. Lamar Alexander (Tenn.) has declined to state how he would vote. His home-state colleague, Sen. Bob Corker (R), however, plans to vote with the Democrats. Alexander and Corker won a promise from congressional leaders that a Medicaid payment problem facing Tennessee hospitals would be fixed in exchange for them changing their positions to support the bill on Wednesday.

Besides Alexander and Corker, the Republican senators who changed their previous positions and voted to pass the bill Wednesday were Johnny Isakson (Ga.), John Cornyn (Texas), Kay Bailey Hutchison (Texas), Arlen Specter (Pa.), Saxby Chambliss (Ga.), Mel Martinez (Fla.) and John Warner (Va.).