House Democrats silence alarm on higher Medicare spending

Washington -- The Democratic-controlled House once again has turned off a warning built into 2003 Medicare statute designed to force lawmakers to confront the issue of rising program spending. This time the silence could last two years.

By a largely party-line vote, the House on Jan. 6 approved a package of rule changes, one of which turned off the Medicare alarm for the rest of the 111th Congress. That warning was first tripped in April 2007, when Medicare trustees predicted for the second year in a row that the portion of total Medicare spending coming from general revenues would exceed 45% within six years. Spending on physician care, hospital care and other services are funded through a combination of general taxes, payroll taxes and beneficiary premiums.

When the alarm sounded in 2007, it established a special fast track for President Bush's proposed Medicare cuts to receive a House vote last year, but Democratic lawmakers stopped the fast track by passing a stand-alone resolution in July 2008. Bush had proposed a package of Medicare reductions that did not include outright cuts to physician pay, but it would have implemented pay-for-performance and public quality reporting for doctors in the program. The 2003 statute does not affect how Medicare reductions receive consideration in the Senate.

In defending their latest action on the Medicare funding alarm, Democratic leaders reiterated that the 45% trigger is an arbitrary measure of Medicare's fiscal health. The original, GOP-drafted procedures "were so poorly drafted that they would allow members to offer unrelated, non-germane and fiscally irresponsible amendments that would have no tendency to address Medicare's long-term financing issues," House Majority Leader Steny Hoyer (D, Md.) said in a statement.

But Republican leaders countered that Democrats are ignoring a real problem with long-term entitlement spending that will not go away simply by silencing the alarm. Experts expect that as long as Congress does not make major reforms, each annual Medicare trustees report will trigger the warning anew.