Washington Democrats not ready to commit on health care bill

McClatchy NewspapersOctober 29, 2009 

WASHINGTON -- Democratic lawmakers from Washington state were hesitant to endorse the revised health care bill unveiled by their leadership Thursday. It wasn't so much because they had problems with it. Rather, they wanted to read the nearly 2,000-page bill before committing.

The exception was Rep. Norm Dicks, D-Wash., who said, "I will be a supporter of this bill."

Even so, the measure includes the top priority of the state's congressional delegation -- overhauling Medicare reimbursement formulas that have long punished Washington because it has one of the nation's most efficient health care systems.

Dicks, along with Washington Democratic Reps. Jay Inslee and Rick Larsen, successfully lobbied House Speaker Nancy Pelosi to include a provision requiring the Institute of Medicine, which is part of the National Academies of Science, to conduct a study of the disparities the existing formulas cause and make recommendations to the secretary of Health and Human Services. Unless Congress blocks them, the recommendations will be adopted.

"What this means for our state is a substantial increase in Medicare reimbursements for Washington physicians and medical facilities, assuring that seniors will be continue to receive the care they need," Dicks said.

Because of the low reimbursement rates in Washington state, some doctors have been refusing to treat Medicare patients, and others were leaving for states that had higher Medicare reimbursements. The problem was especially acute in rural areas.

Rather than a study, the health care reform bill adopted by the Senate Finance Committee actually includes an overhaul of the reimbursement formulas. The Finance Committee bill is expected to be at the heart of a reform bill Senate Democrat leaders are working on.

The House bill is expected to come to the floor next week. Leadership has given members more than the 72 hours they promised to read the bill before bringing it to the floor.

"My hope is we can get this through the House in the next 10 days," Dicks said.

Dicks, who supports a so-called single-payer, entirely government-run health care system, said he was relieved the proposed bill included a public option.

"I would have preferred a more robust public option," he said.

Larsen declined to give the bill an outright endorsement until he reads it, but he noted it included the Medicare reimbursement overhaul, a public option and provisions that will extend the life of the Medicare trust fund and close the so-called doughnut that has resulted in some seniors having to pick up the cost of a major portion of their prescription drugs.

"My initial reaction is this bill is consistent with my principles," Larsen said.

Democratic Reps. Adam Smith and Brian Baird deferred comment until they have read the bill. But Smith, a moderate, had reservations about an earlier bill because it was too complicated and could be too expensive.

Washington state Republicans were quick to criticize the bill unveiled Thursday.

"Here we go again," said Rep. Doc Hastings, R-Wash. "It is evident, though, that this bill is just another government takeover that will result in bigger government and more spending.

"It would ration care, cut Medicare, jeopardize existing health care plans, raise taxes, penalize small businesses and restrict savings tools like health savings accounts - all without lowering costs."

Rep. Dave Reichert said the bill was similar to one he had earlier voted against in the House Ways and Means Committee. To skirt budget concerns, he said, the bill does not include the roughly $250 million in increased Medicare fees Democrats want to pay doctors. The public option was a mistake and the measure would not only tax millionaire couples and small businesses, but would impose a federal sales tax on purchases of wheelchairs, pace makers and hearings, he said.

"Their ultimate goal is to have a government run health care system," Reichert said.

McClatchy Newspapers 2009

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