Politics & Government

Medicare pay cut nixed again

President Bush sought to block a bill Tuesday aimed at forestalling an 11percent cut in payments to doctors taking care of Medicare patients, but Congress quickly overrode his veto for the third time.

The House voted 383-41 to override the veto, while the Senate voted 70-26, in both cases far more than the two-thirds necessary to block the president's action.

With organized medicine and other lobbies promoting the popular measure in an election year, Republicans broke heavily from the White House. A total of 153 House Republicans voted to defy the White House, an additional 24 Republicans from a June 24 vote that started the momentum toward passage of the Medicare doctors' bill Tuesday. Twenty-one Senate Republicans voted for the bill this time, including four senators who had voted “nay” in the two previous Medicare votes.

Sen. Elizabeth Dole, R-N.C., was the only Carolinas senator to vote for the override.

The Medicare bill marks the third bill, along with the recent farm bill and a water resources bill, that has become law despite Bush's veto pen. Overall, he has vetoed 12 pieces of legislation during his presidency, including a “pocket veto” of last year's defense authorization bill.

At issue Tuesday was how the government should respond to a planned reduction in Medicare doctors' fees mandated by a formula that requires the cuts if certain spending targets are not reached. Under the formula, a 10.6percent cut in fees for doctors was supposed to go into effect July 1, but Congress overwhelmingly voted instead to reduce the reimbursement to insurance companies that serve Medicare beneficiaries under its managed-care program. Those reductions would allow the postponement of the pay cut to doctors for 18 months, but would cost the insurers $14 billion over five years.

Bush said the cuts to insurers would harm the managed-care program, which his administration sees as giving seniors more choices and eventually leading to lower health costs for the federal government.

“I support the primary objective of this legislation, to forestall reductions in physician payments,” Bush said in his veto message. “Yet taking choices away from seniors to pay physicians is wrong.” He called the bill “fiscally irresponsible” and charged that it “would undermine the Medicare prescription drug program.”

But Democrats said their legislation would prevent doctors from fleeing the traditional treatment practices that are used by more than 80 percent of the mostly elderly Medicare patients. They said the private insurers were receiving too much funding in the Medicare Advantage program.