Stonewalling Medicare

It’s just the sort of dead-end political fighting sure to irritate voters: GOP leaders held a press conference last Friday to announce they had decided to pass a $28-billion Medicare funding bill, and President Clinton promptly vowed to veto it.

Fortunately, even as Republicans and Democrats confronted each other publicly, both sides were still meeting behind the scenes. After the GOP press conference, Clinton administration staffers met to find compromise with Republican leaders Rep. Pete Stark of Hayward and William M. Thomas of Bakersfield. Another meeting is planned for later this week.

Clinton is rightly troubled by two provisions in the Medicare spending bill, which were added without bipartisan debate, to the great frustration of Democratic legislators.

The first, barring states from offering Medicaid and other federally subsidized health care to legal immigrant children, would deny benefits accorded to other working families. The second, increasing Medicare payments to HMOs while giving short shrift to teaching hospitals, could further destabilize health care in California, where 64% of hospitals are already losing money because of cuts to Medicare in the 1997 Balanced Budget Act.

Clinton also objects to the GOP leadership’s decision not to include an amendment by Sens. Edward M. Kennedy (D-Mass.) and Charles E. Grassley (R-Iowa) that would allow middle-class families with disabled children to buy into the Medicaid program at rates below those of commercial insurance.

GOP hard-liners led by Sen. Phil Gramm (R-Texas) and Rep. Bill Archer (R-Texas) are urging Senate Majority Leader Trent Lott and House Speaker J. Dennis Hastert to oppose any compromise with Clinton. They argue that the president’s veto threat is a bluff because Clinton would never ally his party with impoverished urban hospitals and poor immigrants to the exclusion of seniors who might be helped by higher funding of Medicare HMOs. The Medicare HMOs, complaining of low rates, say that next year they will drop nearly 1 million of the 6 million people they now enroll.

The House leaders surely realize that Archer and Gramm do not represent the mainstream of opinion within the Republican Party. In fact, most GOP leaders support the notion of increasing payments to teaching hospitals, ensuring that children with disabilities don’t lose benefits and extending government subsidized health care to legal immigrant children.

Lott and Hastert should listen to their own moderates, not to the party’s most cynical strategists, and seek the Medicare funding compromise that is so tantalizingly close at hand. A dose of bipartisanship might even lure a few more voters to the polls Nov. 7.