Bush likely to lose on Medicare

President Bush is expected to lose a hard-fought battle with Congress over Medicare legislation as nine key Senate Republicans say they intend to vote to override his veto.

Eight of the GOP senators say they will stand by decisions to switch votes from no to yes when the bill came up this past week. Another senator who voted against the bill says he plans to support the override when the bill comes back after being rejected by Bush.

{mosads}With those senators joining nine Republicans who twice voted for the bill, and the 49 Democrats and two Independents in support, the legislation would have 69 votes — more than enough to trump the White House.

The development is another sign of the waning influence the White House has over congressional Republicans, who are worried that their party's poor approval ratings will lead to major losses during the November elections. Switching their votes to sustain Bush's veto could open them up to attacks from groups representing doctors, the elderly and military veterans, three constituencies they can ill afford to lose in November.

The Senate approved the Medicare bill Wednesday by a 69-30 vote, with nine Republicans who previously voted against the measure switching to support it, in an effort to avert a scheduled 10.6 percent cut in the reimbursement rate for doctors who operate under Medicare. Doctors say access for Medicare beneficiaries would be slashed if the cuts stay in effect.

The nine Republicans switched their votes after Sen. Edward Kennedy (D-Mass.) returned from treatment of brain cancer to cast a decisive 60th vote, ensuring passage of the measure. Four of the nine GOP senators are up for reelection this fall.

With 67 votes needed to override the expected veto, Democrats need to ensure that at least 16 of the 18 Republicans who voted for the measure on Wednesday support an override. The most likely candidates to switch are the nine who had previously blocked the bill but reversed course Wednesday. But if Kennedy could not return for a veto-override vote, then Democrats would need to limit GOP defections to one.

One Republican who voted against the measure Wednesday — Sen. Kit Bond (Mo.) — said he wants to override the president's veto. Bush opposes the bill largely because it pays for the cost of fixing the physician payments by reducing spending on private insurance plans that operate under Medicare Advantage.

"My first concern is protecting both patients and Medicare providers, which is why I will support a veto override despite the Democratic leader's election-year games with this critical bill, which regrettably prevented any opportunity to debate, amend or improve the bill," Bond said.

The nine Republican senators who switched their votes include Johnny Isakson (Ga.), John Cornyn (Texas), Kay Bailey Hutchison (Texas) and Arlen Specter (Pa.), and all said they would vote to override the veto. GOP Sens. Saxby Chambliss (Ga.), Bob Corker (Tenn.) Mel Martinez (Fla.) and John Warner (Va.) also plan to vote to override the veto, their aides say.

“The president has stated his intention to veto the bill, but the margins by which the bill passed in both the Senate and the House are sufficient to override the veto,” Specter said in his weekly message recorded for voters in Pennsylvania.  “Reluctant as we might be to override a veto, it is the general consensus, including mine, that that is necessary.”

Sen. Lamar Alexander (Tenn.), chairman of the Senate Republican Conference and the ninth senator among those who changed their votes,  would not say whether he would override the veto.

"I don't like to predict votes," Alexander told The Hill.

But Alexander, up for reelection this year, would be hard-pressed to sustain Bush's veto since his junior home-state colleague plans to vote for an override. Moreover, after Wednesday’s vote, Alexander and Corker said they changed positions based on a promise from congressional leaders that future legislation would address a Medicaid payment issue facing some Tennessee hospitals. A vote to uphold the veto would jeopardize that agreement.

The House seems to be a safe bet to override the veto, after having approved the bill by a whopping 355-59 vote on June 24, far more than a two-thirds majority. Senior House Republicans have expressed doubt that the rank and file would line up behind the president and risk incurring voter wrath in the fall.

J. Taylor Rushing and Jeffrey Young contributed to this story.