Health debate shifts to entitlement cuts

June 28, 2011

The Hill

Sam Baker

Congressional Republicans have had some success in shifting the healthcare debate back to the reform law, but speculation about health entitlement cuts in a debt-ceiling deal could thwart their momentum.

After weeks of dominating the healthcare headlines, Rep. Paul Ryan’s (R-Wis.) Medicare proposal has taken a backseat to heightened criticism of the Affordable Care Act. Republicans are renewing their assault on the law’s Independent Payment Advisory Board, which they say will "ration" care.

The GOP also seized on a report that up to 3 million middle-class families could become eligible for Medicaid because of the reform law.

But with negotiations over the debt ceiling and spending cuts reaching a critical phase, the focus is likely to shift away from the reform law and onto entitlements.

Democrats and advocates are fighting potential cuts to Medicaid, while industry groups are bracing for Medicare payment cuts that many of them say they can't afford. Little information has leaked out so far, even as the talks fell apart and got kicked up to President Obama and the leaders in the House and Senate.

Hospitals have already been making an aggressive case that they took big hits in healthcare reform as well as through recent regulations; they say it's time for other healthcare sectors to shoulder more of the burden. Medicare's advisory commission recently suggested paying less for imaging services, which doctors didn't like.

Congressional Democrats have proposed taking more money out of the pharmaceutical industry through expanded rebates and Medicare price negotiations, but neither of those proposals has ever found much support among Republicans.

The Senate Finance Committee is scheduled to hold a hearing Thursday on “key issues” in deficit reduction, following up on a hearing last week that focused specifically on healthcare programs.

The National Center for Policy Analysis is holding a briefing Tuesday on Capitol Hill about the future of Medicare, and a coalition of provider groups has a hearing the same day on Medicaid.

Also on Tuesday, the American Enterprise Institute will discuss the importance of innovation in vaccine development, and some 125 physicians come to Capitol Hill to lobby members on painkiller legislation. And the Food and Drug Administration starts a two-day public hearing on whether to review its restrictions on the cancer drug Avastin.

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