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Will Medicare Payoff Payments Live On Cutting Every Minute Shortly Every Minute 2008?

That's the query a poster asked today too it has been an number on my mind. So I volition address it here.

First, CMS has already started the rate setting procedure for 2008 too volition own got it finalized past times early on September. While the Congress makes the rules too tin practise anything it wants, it would locomote really hard to modify the 2008 bargain amongst the person sector afterward early on September.

The only way nosotros would larn a 2008 cutting is if the Congress reauthorized S-CHIP too used private Medicare Advantage cuts to fund the toll of that program. Under the Democratic rules, the Congress will own got to come upwards up amongst either novel taxes or budget cuts to offset whatever spending on S-CHIP.

Since S-CHIP has to locomote reauthorized past times September 30th, you lot tin run across the possibility of a Medicare Advantage cut taking house earlier the 2008 Medicare Advantage rates are finalized.

Most inward the Congress--Democrats too Republicans--would similar to role an increase inward the tobacco taxation as the way to fund S-CHIP reauthorization. The reauthorization procedure is going to get inward the Senate too motion to the House. The Senate Finance Committee wants to own got the number upwards inward the side past times side dyad of weeks.

Republican Senate Majority Leader, Mitch McConnell, all but conceded the votes are at that topographic point to practise it amongst a tobacco taxation increase inward comments he made this week.

There is to a greater extent than involvement inward cutting Medicare Advantage to pay for S-CHIP inward the House.

S-CHIP reauthorization volition eventually larn done but it won't locomote whatever sort of slam-dunk. The hang-up volition locomote inward the details. The Bush administration, and most conservatives, are upset that states own got gone beyond the master copy intent too gone on to embrace children inward families making upwards to 350% of poverty too likewise roofing adults. There volition locomote a lot of arm wrestling around only what the novel rules volition be. Ironically, the Bush management is yet blessing state exemptions to embrace these "extra" people only equally they complain close state activity (on May 30th for Wisconsin, for example).

Also, if Democrats were to top an S-CHIP reauthorizaton bill it volition locomote a standalone bill. That would locomote bailiwick to a Bush veto. You volition retrieve that I own got pointed out that the house Medicare Advantage payments are most at risk is inward the year-end "omnibus" budget bill. That is normally loaded upwards amongst dozens of big items too is the dissever of affair that would locomote really hard for the President to veto.

Democrats demand lots of coin at year-end to counter the automatic 10% Medicare doctor fee cut too to offset come upwards possible infirmary too other provider cuts. The Medicare Advantage cuts are the logical source for this money.

So, afterward all that background here's where I run across things:

1. In the end, it volition locomote amend for the Dems to larn out the Medicare Advantage payments solitary too fund S-CHIP amongst only a tobacco tax.
2. Their best shot at getting concur of the Medicare Advantage money is inward the final omnibus budget bill (at the halt of the 2007 session) that is almost exclusively controlled past times the fundamental House too Senate commission chairs (most of which loathe Medicare Advantage). That nib volition locomote far to a greater extent than insulated from Republican meddling too a Bush veto because it volition locomote larded-up amongst lots of things Congressional Republicans too Bush volition want.
3. If Medicare Advantage is cutting inward the in conclusion omnibus bill--and I think it volition be--then the root touching on the plan volition locomote inward 2009--the Congress volition achieve forwards for those cuts too select some of them dorsum into their multi-year calculation.
4. Now here's my caveat--anyone interested inward this number needs to sentry the S-CHIP bill's progress really closely. What is troubling to me is how poorly worked out the S-CHIP reauthorization outline is. The people inward the optic of all of this actually don't know how they are going to larn it done yet.

When the hateful solar daytime is done, I believe Medicare Advantage cuts volition come upwards inward the year-end omnibus bill. I likewise think the recent MedPAC recommendations offering a reasonable template for how that volition happen.

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