Congressional Democrats Might Use Budget Reconciliation Process To Pass Medicare Bill

Leaders of the House and Senate Budget committees on Tuesday said that they might use the fiscal year 2009 budget reconciliation process to pass a Medicare bill with a provision to prevent a scheduled 10% reduction in physician reimbursements, CQ Today reports. According to CQ Today, use of the budget reconciliation process, which allows legislation to move through the Senate without the threat of a filibuster, is an "attractive option for Democrats who have watched Senate Republicans halt many of their priorities over the past year."

Senate Budget Committee Chair Kent Conrad (D-N.D.) and House Budget Committee Chair John Spratt (D-S.C.) said that they likely will make a decision about whether to use the budget reconciliation process early in the week of March 3 (Clarke, CQ Today, 2/26). Debate on the budget resolution will begin on the Senate floor during the week of March 10 (Johnson, CongressDaily, 2/26).

Senate Finance Committee Chair Max Baucus (D-Mont.) seeks to delay the scheduled reduction in physician reimbursements for 18 months -- a proposal that would cost between $12 billion and $15 billion over five years -- as part of the Medicare bill (Johnson/Cohn, CongressDaily, 2/26). In December 2007, Congress passed legislation that delayed the reduction, previously scheduled to take effect on Jan. 1, for six months (CQ Today, 2/26). Baucus also seeks to expand low-income subsidies for the prescription drug benefit and rural subsidies as part of the Medicare bill.

According to analysts, the Medicare legislation could cost more than $20 billion over five years. "Offsetting that proposal will require Democrats to trim areas that are unacceptable to Republicans, such as private Medicare Advantage plans," CongressDaily reports. Baucus said that "Medicare Advantage is certainly on the table" as a possible source for offsets, as well as individual health care providers and medical education programs (Johnson/Cohn, CongressDaily, 2/26). Republican Response
Senate Budget Committee ranking member Judd Gregg (R-N.H.) on Tuesday criticized the possible use of the budget reconciliation process to pass a Medicare bill. He said Democrats "learned last year that they can use reconciliation as a protection to expand spending in the federal government. I suspect they are going to do that again." He added, "I don't think there is any question they intend to use Medicare Advantage to continue to fund new initiatives" (Johnson, CongressDaily, 2/26).

Senate Minority Whip Jon Kyl (R-Ariz.) said, "In the past we've always used reconciliation to pull back on mandatory spending, reduce taxes, and it certainly is not designed to enable the Congress to spend more money," adding, "And if that's the way it's used, then I think you'll see Republicans resisting very strongly" (Johnson/Cohn, CongressDaily, 2/26).