March 25,2010

Senate defeats Grassley amendment for fair treatment for rural states

WASHINGTON --- Senators today voted to defeat an amendment offered by SenatorChuck Grassley to get rid of a sweetheart deal in the new health care law that gives five ruralstates better treatment than every other rural state, including Iowa. Grassley’s amendment wouldhave used money now obligated to the special deal and improved Medicare payments tophysicians in all rural states this year and next.

Grassley’s amendment also sought to make sure the Department of Health and HumanServices could not undo a formula fix established by a Grassley amendment included in the finalhealth reform bill that became law earlier this week. The Grassley provisions ensure the useof accurate data in geographic adjustments for Medicare payments to physicians and other healthcare professionals.

“The good news is that my formula fix is in the new law. My concern now is that a lastminuteletter from the Secretary of Health and Human Services was added as a side deal to theHouse health care reconciliation bill and could jeopardize the fix. The Secretary’s letter saysthere will be a new study on geographic disparities in order to establish new data for fairtreatment, but that data may or may not be good for rural states, and the study is tied to an effortto reduce Medicare spending, which is not likely to be good for rural states,” Grassley said.

Grassley’s formula fix was added to the health care legislation during Finance Committeeconsideration of the proposal in the Senate last September. It made the Senate bill better forrural health care than the House bill because the House bill included only a study andrecommendations. It didn’t make actual improvements to the status quo for rural providers.

“These formulas need to be established in a way that is equitable and fair. They arefundamentally important to how well Medicare works, or doesn’t work, for beneficiaries in ruralstates,” Grassley said.

Grassley offered his amendment during Senate debate on the health-care reconciliationbill. The five states that benefit from what’s known as the frontier state deal are North Dakota,South Dakota, Wyoming, Montana and Utah.

A number of Grassley amendments and legislative initiatives are in the health-carereform bill that became law on Tuesday. Grassley voted against the overall bill because itincreased taxes and mandates on job-creating small businesses, raised taxes and fees that theCongressional Budget Office said would be passed on to consumers and result in higher healthinsurance premiums, failed to address reforming the Medicare physician payment sustainablegrowth rate formula known as the SGR and, instead, cut Medicare spending not to improveMedicare but to start an unsustainable new entitlement program, and failed to do anything abouthealth care inflation.