George Bush is continuing to threaten to veto the Medicare bill which passed on Wednesday. Bush’s loss of influence can be seen in the number of Republicans who plan to vote to override his veto. In addition to eight of the nine Republican Senators who changed their vote to support the bill on Wednesday, an additional Republican, Kit Bond, has indicated he will vote to override a veto. The bill also passed by a veto-proof margin in the house.
Bush might still go through with his veto threat, despite an inevitable override, to express his support for the bill and insurance companies. Bush and many Republicans oppose the bill as it reduces subsidies to insurance companies to treat Medicare patients. Medicare Advantage plans have been a flagrant example of corporate welfare for the insurance companies, in return for their heavy financial support, providing them with an average of thirteen percent more than it costs to care for Medicare patients under the government plan. Most of the of the extra money is being used to increase corporate profits as opposed to benefiting patients as insurance lobbyists often claim.
With regards to the impact on physicians, it will be helpful if this is settled quickly. Several years ago Congress passed a measure to delay Medicare payments for two weeks as a means of increasing the amount of money on hand for the government. With this built in delay no claims have been paid since the automatic 10.6% reduction came into effect on July 1. If the matter is settled soon, July claims can be paid based on the fee schedule in effect without the cuts. Ideally Bush will sign the bill quickly so that claims can be paid. If he does decide to proceed with his threatened veto, he will hopefully do this quickly so that Congress could then override the veto quickly, also allowing for payment without cuts.
If Bush drags out the process by not signing or vetoing the bill quickly, Medicare will have no legal option but to begin paying July claims based upon the 10.6% cut, and then would have to pay back the money afterwards. This becomes a paperwork headache for all involved, with such a scenario having happened once in the past. This is complicated as many Medicare services include a twenty percent copay, which is often paid by a secondary insurance company. Therefore correction of the 10.6% cut retroactively involves not only a second payment to make up for the cut but a correction for all claims for the change in copay. Republicans are already losing popularity with physicians over the manner in which they have handled this issue, and their popularity could fall further if Bush plays political games and drags out this problem unnecessarily.
