Senate Aging ranking member Gordon Smith plans to tell Senate Finance Chairman Max Baucus today that he will support the Democrats' Medicare physician pay fix bill and will offer to be the lead Republican on the measure.
Smith, who is also on the Finance Committee, and Baucus' staff have been negotiating to add key provisions sought by Smith to the Medicare package, including improvements in access to low-income beneficiary assistance, parity in Medicare co-payments for mental health services and enhanced prescription drug coverage for HIV/AIDS, cancer and other serious illnesses, a Smith spokeswoman said.
Smith's office expects those provisions to be in Baucus' final bill, which members are expected to get more detail on today at a bipartisan members' meeting.
Finance ranking member Charles Grassley conceded Tuesday that some Republican members will cross over despite partisan efforts by Democrats and Republicans to craft their plans to stop for 18 months a 10.6 percent Medicare physician pay cut that is set to go into effect July 1.
"They obviously are going to get some Republicans because some Republicans are up for election," Grassley said Tuesday. He predicted Democrats would not reach the 60-vote threshold required to move virtually any legislation in the Senate.
Smith is likely one of the Republicans Grassley had in mind. He is a prime target of the Democratic Senatorial Campaign Committee and is the only Republican senator from a West Coast state. He faces former Oregon state House Speaker Jeff Merkley, a Democrat, in November.
Sen. John Sununu, R-N.H., who also is on the Finance Committee, is another DSCC target and faces a tough race against former New Hampshire Democratic Gov. Jeanne Shaheen. Sununu's office did not respond to inquiries about the Medicare package.
Sen. Pat Roberts, R-Kan., is on Democrats' short list of potential allies, but Roberts was coy Tuesday. "I don't want to get into specifics," he said. "I'd rather keep my options open." Roberts is up for re-election this year but is far down on the list of Democratic targets.
Another GOP Finance member, Sen. Olympia Snowe of Maine, said Tuesday she will support the Democrats' package, though her admission is not a surprise. She has publicly supported broad Medicare Advantage cuts, a key component of the Democratic package.
Baucus decided almost two weeks ago to move forward with a Democratic proposal rather than continue bipartisan negotiations with Grassley and Senate Minority Leader McConnell.
"It's an exercise in politics that I think demeans the whole Medicare pledge," Sen. Orrin Hatch, R-Utah, said.
The split is mainly over how to pay for the package. Democrats want to cut additional payments for private Medicare Advantage plans while some Republicans would rather focus Medicare Advantage cuts only on what they characterize as duplicative indirect medical education payments.
Private insurers participating in Medicare Advantage are paid more by Medicare to offer services in rural areas as well as extra benefits, but Democrats contend the process creates disparity.
This article appeared in the Saturday, June 7, 2008 edition of National Journal Daily.
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