First Posted: 03- 1-10 02:13 PM | Updated: 03- 1-10 03:21 Pm
Sen. Jim Bunning continues to object to extending unemployment benefits. On Monday, the Kentucky Republican once again prevented a vote on a bill that would extend eligibility for enhanced unemployment benefits and subsidized health insurance for laid-off workers by 30 days.
Senate Majority Leader Harry Reid (D-Nev.) asked for unanimous consent to move forward with the bill. If Congress fails to pass an extension, the National Employment Law Project estimates that 1.2 million people will lose their benefits in March.
"Six times last week, Democrats asked to extend their unemployment benefits for a short time while they work on a longer extension," Reid said. "Six times, Republicans said no. They didn't just say no to us, that is members of the Senate. They said no to their families in their own states and all our states count on us to act when we need action. They count on us to respond in the event of an emergency. This is an emergency. The Republicans in the Senate are standing between these families and the help they need while these benefits expire and expired."
Make it seven. After Reid spoke, Bunning raised his objection and blamed the Democrats for failing to extend benefits with an earlier bill that Reid scrapped. He repeated his insistence that the Senate not add an additional $10 billion to the deficit.
"Just a brief explanation of why we are where we're at with this extension bill, the brief extension of 30 days," said Bunning. "There was an agreement between the majority leader of the Finance Committee and the minority leader in the Finance Committee, Sens. Baucus and Grassley, on a three-month extension of these very same provisions. There were more provisions in the bill also. It cost a little more than the the $10 billion that is asked for because it was a three-month extension. Senator Reid pulled that bill from the floor of the U.S. Senate. He did it. The leader of the Democrats pulled that bill from the floor. I support extending unemployment benefits, COBRA benefits, flood insurance, highway bill fix, doc fix, small business loans, distant network television for satellite viewers. If we can't find $10 billion to pay for something that we all support, we will never pay for anything on the floor of this U.S. Senate."
The bill under consideration provides a stop-gap 30 day extension for several other expiring laws, including funding for highway projects that employed 2,000 people until Monday, improved Medicare reimbursement rates (known as "doc fix"), flood insurance, and licensing that allows satellite TV providers to carry local channels in rural areas where they are unavailable with an antenna. Reid said nearly 1.5 million people in rural access would lose access to their local channels today. (DirecTV did not immediately respond to a request for comment.)
Even if Senate Democrats get around Bunning and pass an extension this week, some recipients of unemployment benefits could miss a check. Before last week, workforce agencies in some states were already sending out letters notifying recipients that they would be ineligible for any of the federally-funded "tiers" of additional benefits provided by the stimulus bill. Eligibility for those benefits ended on Feb. 28; the bill under consideration would push the deadline back to April 5.
Bunning showed some anger when ABC News tried to ask him about his objection on Monday. "Excuse me, this is a Senate-only elevator," he said. "Excuse me!"
It apparently didn't happen on camera, but Bunning also reportedly gave an ABC News producer the middle finger.
AP
Senate gridlock triggers cut to doctors
By RICARDO ALONSO-ZALDIVAR (AP) – 3 hours agoWASHINGTON — Political gridlock in the Senate triggered a 21 percent cut in Medicare fees to doctors Monday, as the American Medical Association warned of a "meltdown" for seniors and the Obama administration scrambled to contain the damage.
Funding to temporarily stave off the cuts was part of a bill passed last week by the House. But the Senate failed to act on the one-month fix because Republican Sen. Jim Bunning of Kentucky objected that the $10 billion measure would add to the deficit.
Republican leaders have since pledged to help pass the temporary legislation. The administration, meanwhile, is ordering Medicare billing contractors not to pay any claims from doctors for the first 10 business days of March, hoping the Senate will move swiftly and physicians can be reimbursed in full. Medicare usually pays electronic claims in 14 days.
But Dr. James Rohack, president of the AMA, said the instability is damaging the popular health insurance program for seniors — and is a harbinger of bigger problems, if Congress fails to act this year on a health care overhaul.
The Medicare cuts are the consequence of a 1990s deficit reduction measure that Congress has routinely waived over the years. But every time the cuts are postponed, they only get bigger in percentage terms, making a permanent fix more costly and difficult.
Rohack says the doctor cuts are a prime example of why postponing action won't work when it comes to high medical costs and millions of uninsured.
"From the AMA's standpoint, if Congress does nothing, things are not going to get better by themselves," Rohack said in a recent interview. "They are only going to get worse, and it's only going to become more of a crisis management situation."
Coincidentally, the Medicare cuts come as the doctors' group opens a major issue advocacy conference in Washington this week. Health and Human Services Sec. Kathleen Sebelius is scheduled to address the AMA on Tuesday.
Newsweek
Congress Cuts Medicare Payouts; Medicare Says 'Oh, No You Don't'
Posted Monday, March 01, 2010 12:10 PM
Mary Carmichael
Let's say an order comes down from the CEO of your company ordering that your salary be drastically cut. You tell your boss you'll have to quit because you can't survive on your meager new paycheck. Your boss says he thinks the pay cut is an atrocity and vows to fight it, but he has done nothing by the time your last full-size check gets written. You're starting to pack up your family photos when suddenly, a miracle: a guy from payroll swoops into your boss's office. "Sir," he says, "don't you want to reconsider this?" Your boss looks thoughtful. "Yeah," he says, "give me 10 more days."
That's essentially what happened in Washington over the weekend regarding the 21.2 percent Medicare pay cut for doctors. Instead of delaying the cut (as it's done every year since 2001, and as the House did late last week), the Senate failed to do anything about it and adjourned for the weekend early. That means the cut technically went into effect today.
But the Centers for Medicare and Medicaid Services, playing the part of the guy from payroll, has stepped in. It's refusing to process any of its biweekly payments to doctors over the next 10 days. That gives the Senate more time to act before the pay cut actually starts hitting doctors' wallets. Maybe it'll use these 10 days to repeal the cut and convince the House to do likewise, making a lot of doctors happy. More likely, it'll just use this brief, artificial reprieve to buy itself even more time.
Why won't Congress just make up its mind about the pay cut, already? "They all say they understand how flawed the formula [that calls for the cut] is," says Lori Heim, president of the American Academy of Family Physicians. But back to our analogy: Even if your boss wants your paycheck to stay the same, the corporate brass may need to cut costs overall. Likewise, even if you think the Medicare pay cut is a horrid idea, it would at least technically do something about the amount the government spends on health care. If the cut goes through, that's $210 billion the government doesn't have to pay out.
That's not fair to doctors, because it effectively pins the blame (and the punishment) for rising health care costs on them. You can certainly argue that doctors who prescribe too much care—whether out of fear of lawsuits or a desire to line their pockets—are responsible for a lot of the increase in health-care costs, as Atul Gawande brilliantly did last year. But not all doctors overprescribe. Yet the Medicare cuts would punish all docs, except those who already refuse to see Medicare patients—and these aren't necessarily the physicians that health-care reform ought to be rewarding.
This week, I have an article in the magazine about increasing the country's ranks of primary-care doctors. Like the flawed pay-cut formula, this is an example of something that everyone claims to agree on. Heim told me that "support for primary care seems to be bipartisan. Congress gets it. The public gets it."
That may be true, but reforming primary care is going to take money. (Yes, better primary care might eventually prevent chronic illness and keep health-care costs down, but first we'll need to provide scholarships to med students, train up more nurses, change the payment system so primary-care docs make more, and so on.) And even Heim balks at the issue of increasing the amount we spend annually on health care. "If we don't address the cost issue now," she says, "we're still going to end up with very expensive medical costs that we can't afford."
That, in a nutshell, is the whole problem with health-care reform, isn't it? The Medicare pay cut may be a small part of the debate, but it turns out to be a microcosm. Everyone agrees that we should fix it; nobody wants to spend a lot of money to make that happen.
