Senate Republicans block cloture vote on Baucus Medicaid bill

WASHINGTON In a vote of 54 to 49, Senate Republicans blocked a call for cloture on S. 3101, the Medicare Improvements for Patients and Providers Act of 2008.

Sponsored by Sen. Max Baucus, D-Mont., the bill had included a number of pharmacy-friendly provisions, and drawn support from numerous industry associations. Steve Anderson, president and chief executive officer of the National Association of Chain Drug Stores earlier in the week had called the measure must-pass legislation.

The bill would have delayed implementation of Medicaid reimbursement cuts for generic prescription drugs, sped up payments to pharmacies in the Medicare Part D drug benefit program and spurred the rollout of electronic prescribing. “The Baucus bill addresses a number of serious, long-standing problems faced by struggling seniors on fixed incomes,” said Howard Bedlin, National Council on Aging vice president for Public Policy and Advocacy. “It corrects deficiencies in the premium assistance program for low-income older people, which has resulted in participation rates of only 13 percent, and removes barriers that impede access to needed mental health and preventive care.”

The bill also would trim payments to private health insurers serving people in Medicare and use the savings to raise reimbursement rates for doctors, which are set to drop by 10.6 percent on July 1. The White House had threatened a veto if the bill was passed in its current form, and Senate Republicans were opting to instead back a similar bill sponsored by Sen. Charles Grassley, R-Iowa, known as the Preserving Access to Medicare Act. Grassley’s bill would replace the scheduled fee cut with a 1.1 percent increase but does not make the same cuts to the Medicare Advantage program as Baucus’.

Republicans now are expecting a return to a more bipartisan bill. “Now that this political exercise is complete, we should return to the negotiating table,” said minority leader Mitch McConnell, R-Ky.

“While S.3101 did not achieve cloture today, America’s 23,000 community pharmacies remain committed to ensuring patients have access to prescription drug services,” Bruce Roberts, executive vice president and chief executive officer of the National Community Pharmacists Association stated. “That outcome can only be achieved by including provisions to speed up the painfully slow payment of Medicare Part D claims and delay utilizing a formula designed to drastically cut reimbursements for Medicaid generic prescription drugs.”

Associations in favor of the Baucus bill were still optimistic. “We are disappointed by today’s outcome,” said AARP Indiana State Director June Lyle. “This bipartisan legislation would have helped more Americans afford their health care bills while bringing our doctors’ offices and pharmacies into the 21st century with e-prescribing. We look forward to continuing to work … to pass a bill this month to improve Medicare and keep premiums fair for the 44 million Americans who rely on the program.”

“Today, an effort to bring the bill up for debate on the Senate floor fell just five votes short. However, nine Republicans voted for cloture, which would have allowed debate on the bill,” the NACDS stated. “The vote of these nine Republicans indicates good potential for bipartisan action in the future. NACDS will continue to work to build support on both sides of the political aisle to advance these important provisions.

“Today’s vote is just the first step in a process that needs to culminate with a health care package, which Congress must pass by July 1,” the NCPA’s Roberts said. “We urge Congress, as it takes the next step, to make sure the pharmacy provisions are included. It is our members’ intention to continue weighing in on this critical debate that will literally determine the fate of patients’ access to community pharmacies.”