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Wednesday, July 9, 2008

Kennedy vote breaks Medicare logjam

By Larry Lipman | Wednesday, July 9, 2008, 04:54 PM

With ailing Sen. Edward M. Kennedy casting a dramatic and decisive vote, the Senate cleared a procedural roadblock Wednesday and ultimately passed a Medicare bill that averts a 10.6 percent pay cut for doctors.

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Two weeks ago, with Kennedy absent after recovering from surgery to remove a malignant brain tumor, the Senate fell one vote short of agreeing to consider the bill. As a result, the scheduled cut went into effect July 1, but Medicare officials said they would not process any doctors’ claims for the first 10 days to give the Senate time to reconsider.

Escorted by Sen. Barack Obama, D-Ill., the Democrats presumptive presidential nominee, and several longtime Senate friends, Kennedy made a dramatic appearance in the Senate chamber during the roll call vote.

Senators on both sides of the aisle leapt to their feet and gave the senior senator from Massachusetts a raucous standing ovation. Among those sitting in the visitors gallery were Kennedy’s wife, Victoria, and his niece, Caroline Kennedy, daughter of President John F. Kennedy.

Kennedy, who has long been considered Medicare’s leading champion in the Senate, is one of only three currently serving senators who originally voted for the program in 1964.

With Kennedy’s vote assuring that the motion to proceed would reach the 60-vote threshold necessary to continue, 10 Republicans who had voted against considering the bill two weeks ago switched sides and voted to immediately bring it to a vote. Among them were Florida Sen. Mel Martinez and Georgia Sens. Johnny Isakson and Saxby Chambliss and Texas Sens. John Cornyn and Kay Bailey Hutchison.

That earlier vote cost Cornyn, at least temporarily, the endorsement of the Texas Medical Association Political Action Committee.

Both Texas senators said they voted for the legislation Wednesday because there was no time left to find a way to prevent the cuts. But both remained critical of the way Democrats handled the issue. Hutchison said the Democratic leadership should have allowed senators to make amendments to the legislation, while Cornyn said Congress still needs to come up with a long-term fix.

The medical association, which represents 43,000 doctors and medical students in Texas, praised both senators for switching their votes.

All of the Senate’s Democrats voted for the bill.

Sen. John McCain, the presumptive Republican presidential nominee, was the only senator who did not vote. McCain has not indicated how he would have voted.

The Senate then approved the bill — passed 355-59 by the House last month — on a voice vote and sent it to the White House where it faces an uncertain future.

President Bush has threatened to veto the bill because it cuts nearly $14 billion from private managed care Medicare Advantage plans over the next five years.

But Senate Majority Leader Harry Reid of Nevada urged Bush to reconsider his threat and said it would be difficult for Republican senators who voted in favor of considering the bill to uphold a veto.

At a news conference immediately following the bill’s passage, Reid said it could not have occurred without Kennedy’s vote, but he now believes the Senate has “more than enough” votes to override a veto.

The White House did not have an immediate reaction to the bill’s passage.

The bill had been overwhelmingly supported by groups representing doctors, hospitals and the elderly, but had been opposed by the managed care industry and the insurance industry.

Bill Novelli, chief executive officer of AARP, the largest organization of those 50 and older, hailed the Senate action and predicted it would “allow people in Medicare to maintain access to their doctors, improve benefits for low-income, prevention, and mental health programs, and boost quality through national e-prescribing.”

Novelli said he hopes Bush “recognizes the overwhelming bipartisan support that passed this bill in both chambers of Congress and signs it into law.”

Dr. J. James Rohack, president-elect of the American Medical Association, also urged Bush to sign the bill.

In addition to averting the scheduled 10.6 percent Medicare pay cut for physicians, the bill would suspend for 18 months a competitive bidding program for medical equipment that took effect in 10 metropolitan areas including Palm Beach, Broward and Miami-Dade counties.

Under that program, only medical equipment suppliers who submitted winning bids are approved to sell new equipment covered by Medicare. Some suppliers would be allowed to continue providing continuing service for items such as portable oxygen machines at reduced prices.

(Austin American Statesman reporter Jason Embry contributed to this story)

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