Despite objections from the Senate’s leading Republican on the topic, House Energy and Commerce ranking member Joe Barton Wednesday maintained that both chambers of Congress have the votes to override a promised veto of legislation delaying for one year seven administration regulations that eliminate or severely cut Medicaid programs.
Senate Finance ranking member Charles Grassley urged members Wednesday — as the Energy and Commerce Committee approved legislation calling for the delay 46-0 — to instead work on fixing the regulations to allow Medicaid to get at liberties some states take with billing that have run up costs.
“Let’s see if he has the votes to do that,” Barton said defiantly.
Supporters of the moratorium argue they need more time to study the regulations to protect states from the $50 billion hole they say the regulations will put in their budgets. “That argument is starting to strain credibility,” Grassley said, pointing to at least two of the regulations proposed at least nine months ago.
Senate Republican leaders refused to comment on where their members would come down on a veto override.
House Energy and Commerce leaders struck a deal last week during a Health Subcommittee markup to address GOP concerns with the cost of the bill.
At the time, Barton said he was “reasonably confident” the administration would refrain from a veto. Instead, HHS Secretary Leavitt sent a letter Tuesday to Barton and Energy and Commerce Chairman John Dingell threatening a veto of the bill.
The bill halts regulations that would have eliminated payments for Medicaid-related administrative activities at schools and specialized medical transportation services for children and hospital outpatient services.
It would also freeze implementation of regulations that would have restricted rehabilitation payments and slashed states’ ability to provide case management services for disabled beneficiaries.
Barton added that overriding a veto is “never comfortable,” but he does not agree with some of the regulations, mainly a proposal to halt Medicaid matching funds for state payments for on-the-job medical training or residency programs known as graduate medical education.
“There is good reason this bill has received broad, bipartisan, unanimous support,” Dingell said in a statement.
The Centers for Medicare and Medicaid Services claims it does not have the authority to make graduate medical education payments.
Dingell pledged to Barton during Wednesday’s markup he would work with the ranking member on separate legislation this year to expressly give CMS authority to cover graduate medical education costs.
The committee shot down a few Republican amendments, including two offered by Health Subcommittee ranking member Nathan Deal, R-Ga., to help pharmacists who foresee crushing reimbursement problems stemming from a pending Medicaid rule.
CMS reworked how it will calculate the “average manufacturer price,” and pharmacists claim this will lead to pharmacy reimbursements for generic drugs that are below the cost to acquire the pharmaceuticals.
Democrats also are concerned with the new formula, and while they rejected attaching it to the moratorium, Dingell pledged to hold a committee meeting to figure out how to get at the problem. He would not promise to move a bill this year.