HFMA VIEWS

Jim Alexander
Technical Director, HFMA

When the conference report of the Deficit Reduction Act of 2005 was modified slightly by the Senate and passed 51 to 50 (the VP casting the tie-breaking vote), it had to be sent back to the House for another vote. You’ve heard a lot about that, as well as the assumption that the Republican majority will prevail again. Well, it was a narrow vote in the House that sent it to the Senate (212 to 206). Recall, too, the opposition to the legislation by the AARP and others (AARP for the Medicaid copayment and asset transfer provisions’ impact on the elderly, advocates for the poor concerned about the discrimination and hardship the poor will experience). The latters’ concerns include the requirement there be proof of citizenship to support eligibility claims, documentary evidence to include birth certificates, and it has been reported that a segment of the African-American population born in pre-boomer years were excluded from the birth recording. 

What happens if just a few votes shift? The highest profile item, the physician 0 percent update, goes away and physicians have to contend with the 4+ percent reduction CMS had to put in place January 1. And then there are the numerous provider provisions, some actually positive, like the IRF transition to the 75 percent rule. But if votes shift enough, it’s continuation of current law. And we’re probably talking gridlock ad nau·se·am.

Bottom line--don’t bank on the DRA just yet.