Right to Life group seeks to bind lawmakers on Medicare

In the past year, a prominent pro-life group has launched a lobbying campaign to shore up congressional support for a controversial Medicare health plan, but so far appears to have gained little traction in the effort.

Senators on the Finance Committee who oppose rights to abortion, euthanasia or assisted suicide say lobbying by the National Right to Life Committee has little — if anything — to do with their opposition to cutting a particular type of private health plan that provides benefits under Medicare Advantage. In the House, Democrats with similar principles had echoed the group’s concerns before overwhelmingly voting for a bill the group strongly opposed.

{mosads}When senators return to Capitol Hill next week, rewriting the Medicare law will be high on the agenda of the Finance Committee. And despite the National Right to Life Committee’s concerns, Democrats appear poised to propose cuts to the program, and some Republicans seem open to them.

Right-to-life advocates say Medicare Advantage private fee-for-service plans are the only type that provide protections against beneficiaries dying as a result of being denied care, which they believe to be tantamount to forced euthanasia.

Unlike other private health plans in Medicare, private fee-for-service plans permit beneficiaries to use their own money to pay for uncovered services.

One Finance Committee Democratic aide told attendees at a Sept. 25 conference of the America’s Health Insurance Plans that the National Right to Life Committee would be a player in the Medicare debate.

 “That is a real political force that is very much supportive of the private fee-for-service program the way it looks right now,” Shawn Bishop said. She added, “If I were to guess about what a Senate package could look like, I would guess that there [were] going to be changes to that product.”

Still, the National Right to Life Committee is warning pro-life lawmakers that it plans to designate the issue as a key vote on its report card for the 110th Congress. This move could put committee Republicans in a difficult spot as they attempt to reach a bipartisan accord on a new Medicare bill.

One of the Democrats’ preferred targets for cuts is Medicare Advantage, but the program enjoys strong support among most Republicans. Democrats justify their scrutiny of the program, in part, based on findings that it costs more to cover a patient through private plans than through traditional Medicare.

Private fee-for-service plans, the most expensive health plans in Medicare Advantage, are the ones the National Right to Life Committee is determined to protect. Anti-euthanasia activists were instrumental in the creation of these plans in the late 1990s.

The organization makes a similar argument against most managed care plans in Medicare and the private sector, such as HMOs and PPOs.

This year’s involvement of the prominent right-to-life group, which has made this Medicare bill one of its top legislative priorities, puts some of their traditional allies in a bind.

In order to cut a deal on crucial Medicare bill this year, Senate Republicans may be compelled to accept some cuts to Medicare Advantage, even if doing so would tarnish their voting records. The House already passed large-scale cuts to Medicare Advantage, though any cuts that might eventually emerge are likely to be substantially smaller.

“They’re key-voting this vote on the Medicare Advantage payments, which means regardless of their substance, people are afraid of having their abortion/euthanasia record tainted by having taken this vote in opposition to what they want,” a representative of a Medicare beneficiary advocacy organization said.

Asked whether the National Right to Life Committee’s activities on Medicare would unfairly hurt friendly lawmakers, an official at the group said it would stand on principle.

“We are a single-issue organization,” said Burke Balch, director of the National Right to Life Committee’s center for medical ethics. “No issue is more important than this because, as we see it, the lives of literally millions of people are at stake here.”

Finance Committee Republicans questioned about this issue by The Hill, however, expressed no knowledge of the National Right to Life Committee’s campaigning, or said the right-to-life issue had no bearing on their opinions about the Medicare bill.

Sen. Pat Roberts (R-Kan.) said he’s wary of cutting Medicare Advantage but professed no group has contacted him about the issue. “The right-to-life thing hasn’t played into it. It’s just the value of the program” that motivates his support for Medicare Advantage, he said. Dating back to the 105th Congress, Roberts’s voting record has a 100 percent score from the National Right to Life Committee.

Finance Committee ranking member Chuck Grassley (R-Iowa) is at the center of the Medicare negotiations and has won perfect marks on the National Right to Life Committee’s scorecard in the last five Congresses.

Grassley also is a strong supporter of Medicare Advantage, and a harsh critic of the House Democratic proposal to deeply cut the program. Nevertheless, Grassley has signaled a willingness to scrutinize payments to private fee-for-service plans, raising concerns over costs, marketing practices and other issues.

Grassley would not rule out imposing cuts to the program. “Do we have too much of a subsidy? I haven’t come to a conclusion yet,” he said.

Finance Committee Republicans Orrin Hatch (Utah), Trent Lott (Miss.), Jon Kyl (Ariz.) and Mike Crapo (Idaho) were unaware of the group’s lobbying efforts. All have perfect or near-perfect scorecards with the group.

Although the right-to-life activists’ messages do not appear to have crossed some senators’ radars, their efforts paid some limited dividends when the House considered its Medicare bill this summer. Although the bill passed the lower chamber, 18 House Democrats who oppose abortion rights wrote Speaker Nancy Pelosi (D-Calif.) objecting to the overhaul of private fee-for-service plans. But most of the 18 voted for the bill.

In the Senate, Finance Committee Chairman Max Baucus (D-Mont.) said last week he wants to move the Medicare bill quickly and suggested that if House and Senate Democrats can’t strike a deal with the GOP, they may skip regular order and negotiate a final compromise bill among themselves.

Lawmakers are intent on moving the legislation, the centerpiece of which would prevent a 10 percent cut in Medicare’s payments to physicians. The Finance and House Ways and Means committees, though, must agree on how to cover the cost of the physician language, which is expected to be around $20 billion.