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Tuesday, March 22, 2011

Rehberg still working to defund health care


 
Written by
LEDYARD KING 
Tribune Washington Bureau


WASHINGTON — Denny Rehberg has been told that his proposal to defund the sweeping health care law President Barack Obama signed last year would add billions of dollars to the federal deficit and prevent senior citizens from using the Medicare Advantage program. He also was told that it has no chance of getting past the Democrats who run the Senate.

No matter. The Montana Republican and his fellow GOP lawmakers are committed to euthanizing "Obamacare," as Republicans dubbed the law, because they believe it represents an overreaching, unaffordable use of federal power, and because that is what they say the voters elected them to do.

"It's a national problem that needs a national solution," Rehberg said of health care. "We're just trying to reason with the members of the Senate that we believe that this is not going to work out the way they want it to, and I think we have the American public on our side on this."

Wednesday will mark the one-year anniversary of a law officially known as the Patient Protection and Affordable Care Act that continues to consume Congress.

Tea-party backed Republicans, such as Rehberg, see repeal of the act as their No. 1 priority.

Democrats, including Sen. Max Baucus, D-Mont., who helped lead the bill's passage, are fierce in its defense. The law figures to occupy a prominent role in the 2012 race between Rehberg and Sen. Jon Tester, D-Mont., a backer of the law and the man Rehberg hopes to replace.

Last week, Rehberg and 53 other conservative Republicans broke from GOP leadership to oppose a temporary spending bill that avoids a government shutdown — for now — in part because defunding of health care was not part of the package.

Democrats and supporters of health care reform have been aggressive about highlighting recent reports suggesting that even the act of barring the administration from using money this year to carry out the law's gradual implementation poses unintended consequences that will cost money and hurt senior citizens.

The nonpartisan Congressional Budget Office projects defunding would have some initial savings this year, but then add $5.7 billion to the deficit over the next decade, partly because it would postpone efficiencies the law tries to achieve, according to an analysis Rehberg requested. Rehberg said the March 10 analysis is based on faulty assumptions. And even the budget office cautions that the budgetary effects of defunding the law are "highly uncertain and depend largely on how the administration would interpret the legislation."

Supporters often point to the long-term savings the bill is advertised to achieve more than $1 trillion over the next 20 years, according to the budget office, as it expands coverage to Americans. But skeptics such as Rehberg say nobody truly believes that providing coverage to millions of previously uninsured people will do anything but cost taxpayers in the long run.

Rehberg also isn't buying Health and Human Services Secretary Kathleen Sebelius' assertion that defunding would preclude her agency from carrying out certain programs, notably Medicare Advantage, which offers supplemental medical services to about 26,000 senior citizens in Montana. In a March 8 letter to Baucus, who is the Senate Finance Committee chairman, Sebelius said Rehberg's defunding proposal would strip the agency of the authority to pay Medicare Advantage providers, and there would be no way to go back to the former payment method because it was abolished by the new health care law.

"Reasonable people can disagree about elements of the health care reform law, but we can't let politics get in the way of the health department's ability to provide Medicare for seniors," Baucus said Friday.

Rehberg disagrees with Sebelius' conclusion, saying his plan touches only discretionary spending, and therefore shouldn't impact mandatory programs such as Medicare Advantage. He said he believes the assertion is political and meant to scare people into opposing his plan.

"You have to assume that the administration and the Democratically controlled Senate are going to do everything to protect the program that they passed, so they will portray it in the best light they possibly can, whether they fudge the numbers or they use accounting gimmicks or not," Rehberg said. "They are going to defend Obamacare in every way, shape or form."

Jessica Santillo, a spokeswoman for Health and Human Services, said defunding would have a "very negative impact on Medicare beneficiaries."

The law "made numerous improvements to payment formulas for hospitals, physicians and other providers, and created important new benefits for seniors, including an annual wellness visit and waiving cost-sharing for critical preventive services," she said. If defunding went forward, it "would delay payments to providers, delay new benefits for seniors and increase the deficit. These delays and cutbacks would inevitably hurt health care providers and negatively affect beneficiaries' access to care."

Rehberg said he is particularly perplexed over the administration's defense of Medicare Advantage, considering that the health care law will cut tens of billions of dollars from the program.

Opponents of defunding say the law reforms the program and stops huge overpayments to private insurance companies without reducing benefits. Cutting back on payments to insurers is expected to prolong the life of Medicare by at least 12 years, according to an analysis by the Centers for Medicare and Medicaid Services.

Rehberg said he is not an opponent of government health care. Quite the contrary, as he views his fight against the health care reform law as a fight to protect the long-term viability of Medicare, even if it earns him some political bruises.

"I have a responsibility to do the right thing whether it helps or hurts me. That does not matter," he said. "I lay awake thinking about if I don't help try and stop the kinds of changes they're trying to make in health care, I will look back some day and have to look my children in the eye and say, 'I'm so sorry for what we did in 2011 or we did in 2012 to affect your health care."'

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