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Published: Thursday, August 2, 2007
House passes health bill, tobacco tax increase
Los Angeles Times
WASHINGTON - A divided House on Wednesday approved sweeping health care legislation that would expand government benefits for children, seniors and doctors while boosting tobacco taxes and cutting Medicare payments to private insurance companies.
The largely party-line 225-204 vote came after hours of debate and parliamentary stalling tactics by Republicans. Cheers rang out in the House chamber when Speaker Nancy Pelosi, D-Calif., announced that the legislation had passed.
The bill - a wish list that expresses the pent-up desires of Democrats after more than a decade in the minority - would expand a popular health insurance program mainly for children in working-poor families. It also would improve preventive benefits for Medicare recipients, provide low-income seniors more help - particularly with prescription costs - and roll back a scheduled 10 percent cut in Medicare fees for doctors.
The legislation faces a veto threat from President Bush and stiff opposition from GOP leaders, who have denounced it as a step toward government-run medicine. The Senate is expected to finish work on a compromise bill later this week that deals only with the children's program, not with Medicare. Republican and Democratic senators are trying to line up a veto-proof majority, because Bush also opposes that measure.
"If they fail to reach a compromise on covering kids, it would be pathetic," said Drew Altman, president of the nonpartisan Kaiser Family Foundation, an information clearinghouse on health care issues. "If they can't agree on kids, what will they be able to reach a deal on when it comes to health reform? Failure to reauthorize (the children's program) would damage many of the most important state health reform efforts around the country."
Created by a Republican Congress in 1997 and signed into law by President Clinton, the program insures about 6 million children whose parents make too much to qualify for Medicaid but too little to afford private insurance. Still, between 8 million and 9 million children remain uninsured, and most qualify for help through government programs.
Washington contributes about $5 billion a year to the children's program, which covers most of the cost. States design their own coverage plans, and most have opted to rely on private managed-care plans to insure children. But with the rising cost of health insurance, current funding levels can't sustain the program. Some states already have seen funding shortfalls, and California might face that predicament as early as next year.
The House bill would add $50 billion to the program over five years, for a total of $75 billion. That would allow it to cover about 5 million more children.
The Senate bill would add $35 billion over five years and cover about 3 million more children.
Many Republicans say that's too much money.
"We want to reauthorize (the program) - that fact cannot be emphasized enough," said Rep. Jim McCrery, R-La. "But we cannot support this proposal. Democrats want to raise taxes ... to fund a massive expansion of government-controlled health care."
In the heat of the debate, some Republicans accused Democrats of wanting to expand the program to cover illegal immigrants and of trying to foist a "hidden tax" on private insurance.
Democrats called those charges distortions.
The bill would give states the option of covering children of legal immigrants. It would allow states to establish their own methods for verifying citizenship.
"The (bill) does not allow one single dime to be spent on illegal immigrants," said Rep. John Dingell, D-Mich.
The tax on insurance turns out to be a $2-per-person fee that would be used to fund research into cost-effective treatments, which in turn could save money for individuals, employers and government programs, said a Democratic aide.
Both bills would more than double tobacco taxes - the House bill would raise the 39-cent tax on a pack of cigarettes by 45 cents, and the Senate measure would raise it 61 cents.
To cover more children, improve benefits for seniors in Medicare, and roll back fee reductions for doctors, Democrats want to cut payments to private managed-care plans that participate in Medicare. Congressional analysts have found that those fees are inflated by about 12 percent per beneficiary when compared with the cost of caring for seniors in traditional Medicare.
But doing that, according to the health-insurance industry, would force about 3 million seniors - about one-third of those enrolled - out of Medicare managed-care plans. Those seniors would lose the often richer benefits that managed-care plans offer, and would have to fall back on the traditional program. The industry, joined by the U.S. Chamber of Commerce, is waging a lobbying effort to block the reductions.
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