Grassley asked Vilsack to contact Sen. Tom Daschle and encourage him to schedule a vote on the Medicare provider legislation containing the initiatives that would benefit Iowa before the congressional session ends this year.
Few legislative days remain, and yesterday Daschle said that there's only a 50/50 chance that a provider bill will be considered. As the Senate Majority Leader, Daschle determines which calendar items are brought up for a vote. Grassley has made direct appeals to Daschle for action on the Medicare legislation citing its importance to Iowa and other rural states that get shortchanged by Medicare for providing cost-effective, high quality health care.
"The situation in Iowa is so urgent that we all need to work together in support of this legislation," Grassley said in a letter to Vilsack. Grassley said he was concerned that dismissive comments by the Governor about Grassley's Medicare legislation, which is supported by members of the Iowa congressional delegation, may undermine efforts to increase Medicare funding to Iowa.
In May, Grassley introduced legislation he titled the "Improving Our Well-being Act," or the IOWA bill. Most every element of this comprehensive proposal was included in a broader legislative package for Medicare providers that Grassley and Sen. Max Baucus crafted during the last month, including a Medicare formula fix for hospitals first sponsored in the House of Representatives by Rep. Jim Nussle. Grassley is the top Republican and Baucus is the chairman of the Senate Committee on Finance, which is responsible for Medicare policy.
The Nussle amendment along with additional provisions for Iowa hospitals in the Grassley-Baucus bill, S.3018, would provide $340 million to Iowa over the coming decade. A change to Medicare's geographic adjustment for physicians in the Grassley bill, along with a reduction to payment cuts slated to occur under current law, would provide $220 million for Iowa physicians during the next three years. And additional Medicare dollars would go to Skilled Nursing Facilities, home health agencies and certain other health providers. The effect of these provisions has not yet been estimated.
In addition to its Medicare provisions, the bill also provides an additional $134 million in Medicaid dollars for Iowa during the next three years, many of which would flow through to Iowa hospitals and nursing homes.
A copy of Grassley's letter to Vilsack follows here.
October 4, 2002
The Honorable Thomas Vilsack
Governor of Iowa
State Capitol
Des Moines, IA 50319
Dear Governor Vilsack:
I am writing to respond to comments you made, reported by the Lee Newspapers on October 2, describing the Iowa Congressional delegation's attempt to increase Medicare fairness to Iowa as a "Band-aid approach" that would provide only about "$130 million" to our state. At the same time, you implied that your proposed lawsuit to increase funding to Medicare HMOs is a more important effort. I'm concerned that your dismissive comments at such a critical time may undermine our efforts to increase Medicare funding to Iowa, so I feel compelled to correct these misunderstandings.
As Ranking Member of the Senate Finance Committee, I introduced Medicare legislation this week with Chairman Max Baucus (D-Mont.) based in large part on the IOWA Bill, which I introduced in May. The Baucus-Grassley bill, S. 3018, would provide over $560 million -- not $130 million -- in additional Medicare funding to Iowa. That's more than four times as much as the number you cited.
As for your contention that my bill is only a "Band-aid approach," I urge you to listen to Iowa physicians, hospital administrators, and other health care professionals. They have made it clear that the Baucus-Grassley bill, along with the Medicare legislation already passed by the House of Representatives, is critical to their economic future. They understand that the bill would be, by far, the biggest stride toward Medicare fairness that has ever been made.
Your state government website, on the other hand, urges support for another bill, S. 1020, the FAIR Act. But the reality is this: S.1020 has always been seen on Capitol Hill as a mere political "statement," and it is a non-starter which has not and will not come up for a vote. It thus offers no chance of providing even one cent to Iowa. The Baucus-Grassley bill, in contrast, is the one that does have a chance. It's important that you clarify to Iowa providers and to the public that you understand the critical importance of my legislation and that you support it.
I appreciate any effort to call attention to our Medicare problem, so let me make it clear that I welcome the interest in Medicare that you have expressed in the last few months. I have been supportive of your lawsuit strategy, but let me explain what your proposed lawsuit would and would not do. As you have described it, it would only affect payments to Medicare+Choice plans, also known as Medicare HMOs. At present, only Pottawattamie County has such a plan, so the other 98 counties would see no benefit in the foreseeable future from the lawsuit. The lawsuit would not deliver any additional funds to our struggling hospitals, physicians, nursing homes, home health agencies, or any other providers of health care in our state. While it would be nice to have Medicare HMOs in Iowa, increasing payments to these insurance companies is in no way a substitute for increasing payments to our health care providers.
There is a way for you to be helpful in my fight for Medicare fairness for Iowa. In particular, you could help by urging the Senate Majority Leader, Senator Daschle (D-S.D.), to schedule a vote on my legislation before the Senate goes out of session this year. The House of Representatives has acted, and the ball is now squarely in Senator Daschle's court. The situation in Iowa is so urgent that we need to work together in support of this legislation.
Sincerely,
Charles E. Grassley
United States Senator