Republicans, Democrats Exchange Fire Over Medicare Rescue

Republicans and Democrats wrangled and fought about Medicare at a contentious congressional hearing Thursday, giving a preview of a hot election-year question: Who should take the blame for the health program’s financial problems?

Rep. Bill Archer (R-Texas), House Ways and Means Committee chairman, said that President Clinton should offer Congress a new Medicare rescue plan “that avoids shell games and tax increases.”

Returning fire for the Democrats, the ranking minority member, Rep. Pete Stark (D-Hayward), lectured his GOP colleagues: “You are still scaring seniors. It’s time to stop.”

The tone of the hearing made it clear that the chances of a legislative fix for Medicare this year are nil. Both parties hope that they can gain an edge in the fierce debate over the federal program that serves 34 million people over age 65 and 3 million disabled Americans.

The hearing was billed as a discussion of the report of the government trustees, who said Wednesday that Medicare’s hospital trust fund will be exhausted in 2001, a year earlier than previously forecast.

Two of the Medicare trustees, Treasury Secretary Robert E. Rubin and Health and Human Services Secretary Donna Shalala, were witnesses. For the GOP majority on the committee, Rubin and Shalala were inviting targets because they represent the administration’s policies.

Although agreement was minimal, both sides acknowledged the need to save Medicare.

“It’s very essential we make every effort to assure 37 million Americans [that] their benefits are [there] and will be there for them,” Shalala told the committee. “Claims will be paid.”

Asked if there is a contingency plan should Medicare go bankrupt, Rubin said flatly: “It can’t happen. . . . It is not a realistic problem for the American people.”

A GOP California congressman, Bill Thomas of Bakersfield, his voice rising in anger, accused the administration of misleading the public with its plan that would shift $55 billion in home health care spending from the troubled trust fund to Part B of Medicare, which is financed largely with general tax revenues.

Shalala said that such a proposal had been endorsed by 227 Republicans in the Medicare plan they offered last year.

But the GOP’s current plan does not include any shift of funds, Thomas said.

“We haven’t seen the details of your plan,” Shalala said.

At times, Thomas, Rubin and Shalala all spoke at once, each straining to make their political points.

Meanwhile, Democratic and Republican staff members were buzzing around the press table, distributing a blizzard of paper, statements, charts and graphs to buttress their bosses’ arguments. But the bitterness of past battles makes an election year compromise virtually impossible. The Republicans proposed $270 billion in savings by restricting the growth of Medicare as part of their balanced-budget program. Clinton vetoed the plan last year and accused them of trying to use Medicare to fund tax cuts for the rich.

This year’s version of the Republican program calls for $168 billion in future Medicare savings over the next six years, while the president has suggested $116 billion in savings over that time.

Shalala said that the rival plans have some common ground. Both agree on the need to save money for Medicare by:

* Strengthening controls against fraud and abuse.

* Reducing the growth rate in payments to doctors.

* Changing the method of paying health maintenance organizations that have government contracts to care for Medicare beneficiaries.

* Adopting a system of payments fixed in advance for home health care services. Currently, the prospective payment system, a fixed sum for each diagnosis, applies only to hospital care.

* Trimming spending for medical education.

“We’d like to bring our proposals to the table and you bring your proposals to the table,” Shalala told the Republicans.