Friday, February 2, 2007

Bush Defends Medicare Advantage Plans--That and Five Bucks Will Get You a Six Pack

President Bush will shortly release his new budget. He will cut $70 billion from Medicare--largely from providers--and leave Medicare Advantage payments unchanged.

President Bush's budget is about as close to irrelevant as it can be. The Democratic Congress will start from scratch.

Doctors and hospitals have enormous clout on the Hill. Just as doctors have been able to protect their Medicare fees from the regular 5% "Sustainable Growth Rate" cuts so many years in a row, they will do so again. Democrats are just as close to the provider lobby as were the Republicans. If Republicans couldn't make these hard Medicare provider choices on the budget how does anyone expect the Dems to do so????

One of the more laughable contentions circulating in Washington today is that the Bush veto is going to protect Medicare Advantage plans from payment cuts. All you have to do is look at how the year-end "omnibus reconciliation" process works to know his veto will do no good once the Dems figure out just how much money they need from Medicare Advantage.

Last December, the Republican Congress wrote one giant "omnibus reconciliation" bill that combined 19 tax cut extensions, three trade bills (Andes, Vietnam, and Sub-Saharan Africa) and I don't know how many hundreds of other items. They also dropped a $7 billion cut to the Medicare Advantage stabilization fund into the final budget bill to override the "Sustainable Growth Formula" 5% cut to Medicare physician doctor fees for one year.

Congressional chairmen have enormous power to decide what is going to be in this last budget reconciliation bill. There were many things in last December's bill that never passed either house of Congress--like the health savings account (HSA) enhancements that became law in this bill.

Last year it was Republican chairman that drove the process. This year it is all Democratic chairman--and some very liberal Medicare Advantage haters at that (Dingell, Rangel, Stark, Kennedy).

My point is that if the Dems want to cut Medicare Advantage "over payments"--and they do--they can get them in the final "omnibus" package. If Bush wants to veto this year's package with this year's tax cuts, trade agreements, and the rest, he can. But the Dems will be smart enough to lard it up with things he has to have in order to protect the things they want.

Would Bush veto the whole final budget bill over Medicare Advantage payments and force a government shutdown-style show-down just to protect the extra Medicare Advantage payments? Dream on.

Get over it, Medicare Advantage payments are going to be cut!!!!

Don't bother to even read the Bush budget. This "lame duck" President is finished.

My post on why the Dems will change Medicare Advantage.
My post on how Medicare Advantage cuts will be used to fund the budget.
My post on why the Bush tax credit proposal will not be enacted anytime soon.
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