Blue Dogs, Obama Agree on Proposal for MedPAC with Muscle

WASHINGTON—In a move that could help break the stalemate over the House health care reform bill, President Barack Obama and seven conservative Blue Dog Democrats agreed in a meeting Tuesday to work toward an independent body to establish Medicare payment rates.
           
Wary of the cost of the proposed reform bill, which is currently undergoing markup by the House Energy and Commerce Committee, the Blue Dogs have delayed the process, saying the bill does not do enough to rein in costs among a host of other disagreements. The committee is scheduled to continue its markup today; the House Ways and Means and Education and Labor committees have already approved the bill.
 
The Congressional Budget Office has said creation of an independent council could help reduce costs, according to Arkansas Rep. Mike Ross, who attended the White House meeting. Ross, a former HME owner, chairs the Blue Dogs’ Health Care Task Force.
 
While the Obama plan is not completely fleshed out, it has merit, according to Ross.
 
“It’s in the infant stages, but I think it’s a significant breakthrough,” Ross told reporters.
 
Obama, who is pushing to get the health reform bill through the House, last week called for the creation of what he dubbed the Independent Medicare Advisory Council. Sort of a MedPAC with muscle, the IMAC would have the authority to establish Medicare payment policy and rates, including for home medical equipment. The current Medicare Payment Advisory Commission is limited to making recommendations to Congress, which the President said are largely ignored and end up “sitting on a shelf.”
 
“What we want to do is force Congress to make sure they are acting on these recommendations to bend the cost curve each and every year,” Obama said.
 
While its components have not been determined, in his legislative proposal for the new council Obama suggested that it:
 
--Have authority to establish Medicare payment rates and policy that could only be overturned by congressional resolution;
--Provide two sets of recommendations annually, one by Oct. 1 that would focus on payment systems operating on a fiscal-year basis, the other by Dec. 31 for calendar-year systems, including HME;
--Be comprised of five paid members, physicians or experts in health policy, appointed to five-year terms by the President with the consent of the Senate;