MEDICARE LEGISLATION ENACTED; APPROPRIATIONS DEFERRED
December 11, 2003
On December 8, President Bush signed into law the largest expansion of Medicare since the program's inception in 1965. In so doing he capped off a lengthy and sometimes bitter battle in Congress over how best to launch prescription drug coverage for millions of seniors and disabled individuals.
The new Medicare Prescription Drug, Improvement and Modernization Act of 2003 adds a drug benefit for elderly and disabled Medicare beneficiaries in 2006, encouraging insurance companies to offer private health plans to those now in the program. In the interim, Medicare participants can purchase a drug discount card that offers added benefits for those with very low incomes.
Although most of the nation's attention was drawn to the prescription drug component of the Medicare bill, the legislation that Congress adopted November 25 also contains other important changes to health care law, including a two-year fix in the way Medicare payments to physicians are calculated. Included in the 1100-page bill, for example, is a provision that blocks a scheduled 4.5 percent reduction in physician payments, replacing it with a 1.5 percent increase in payments for 2004 and 2005. In addition, the bill lends special relief to physicians practicing in rural areas.
Consolidated Appropriations Bill Stalled
While passage of the Medicare prescription drug plan was hailed by many as a monumental feat, Congress adjourned December 9, leaving behind a roadmap of unfinished business for next year. Among the major legislative issues to be addressed when Congress returns in January are: energy, highway transportation, renewal of welfare reform legislation, pension overhaul, medical malpractice reform, mental health parity and genetic non-discrimination.
But by far the most critical item left stranded this year is a $328 billion appropriations bill to fund 11 federal government departments, including Health and Human Services, Education and Labor. The so-called Consolidated Appropriations Bill serves as a catch-all for all but four federal departments-Defense, Homeland Security, Interior and Energy-whose appropriations bills were enacted earlier this year.
Because the White House and Congress were unable to agree on a number of controversial, mostly non-money matters until it was too late, the 11 departments and related agencies must operate on a continuing resolution set at the fiscal year 2003 funding level.
The House-Senate conference agreement on the 1,182-page omnibus bill was filed just hours before Congress recessed for Thanksgiving. The House returned to work December 8, and passed the measure by a 242 to 176 vote. But for the second year in a row, Congress failed to complete its appropriations work before adjourning, when Senate lawmakers on both sides of the aisle balked at passing a bill of this size and breadth without extensive debate.
At issue were last-minute deals struck by the majority Republicans and the White House on provisions dealing with media ownership, overtime compensation, country-of-origin labeling for meat and produce, and firearms sale documents. Facing a filibuster threat, Senate majority leader Bill Frist (R-TN) filed a motion to close off debate, a motion that will be voted on when the Senate re-convenes January 20. If the required 60 votes are garnered, the Senate will proceed to a vote on the Consolidated Appropriations Bill. If not, the affected departments and agencies will remain under the current continuing resolution, which runs through January 31.