Capitol Hill Watch: Obama agenda under scrutiny as lawmakers talk Medicare, budgets

President Obama's agenda, which includes a sweeping overhaul of the health care system, is coming under increased political scrutiny as lawmakers struggle with health budget challenges, and consider issues such as medical bankruptcy and improper Medicare payments.

In a news analysis, The New York Times reports that President Obama is pushing through his agenda while taking cover from political flak in an attempt to pass sweeping legislation. "But Mr. Obama's legislative success poses a paradox: while he may be winning on Capitol Hill, he is losing with voters at a time of economic distress, and soon may be forced to scale back his ambitions. The financial regulatory bill is the final piece of a legislative hat trick that also included the stimulus bill and the landmark new health care law. Over the last 18 months, Mr. Obama and the Democratic Congress have made considerable inroads in passing what could be the most ambitious agenda in decades" (Stolberg, 7/15).

As Obama prepares to continue to sell his agenda, lawmakers are proposing new legislation that would alter the health care landscape. The Hill's Healthwatch Blog reports that "Reps. Mary Jo Kilroy (D-Ohio) and Mac Thornberry (R-Texas) on Thursday proposed legislation expanding Medicare prescription drug coverage to include more off-label uses." Right now Medicare Part D plans are prohibited from covering off-label uses of non-cancer drugs, even if supported by peer-reviewed medical literature. "Medicare's prescription drug benefit, which initially didn't allow plans to cover drugs for any off-label uses, was amended in 2008 so that off-label drugs used for cancer treatment would be permitted. But plans still can't cover off-label drugs used to treat other conditions." The bill would allow for some off-label use of drugs in Part D (Lillis, 7/15).

CongressDaily: The Department of Health and Human Services, in the meantime, saw its draft fiscal year 2011 budget pass an appropriations subcommittee Wednesday "to provide $271 million over the president's request to HHS." The bill would appropriate more money to HHS because of an "influx of funds to public health efforts. … The bill fully funds the president's NIH request with a $1 billion increase and includes an 80 percent increase to $561 million in funds for a healthcare fraud program at HHS and the Judiciary Department" (McCarthy, 7/16). 

The Hill's Healthwatch Blog, in a separate item: In another subcommittee hearing, experts testified on medical bankruptcy at a hearing of the House Judiciary Committee's Commercial and Administrative Law subpanel, which was considering a bill on the issue Thursday, "The bill would amend federal bankruptcy law to allow people with medical debt to exempt as much as $250,000 of their home or burial plot's value from the estate in bankruptcy." The experts disagreed, however, on how widespread the problem is with some saying many get into credit card debt to pay for medical bills and others saying a survey from 2007 reports only 2.4 percent of families reported any medical debt (Pecquet, 7/15). 

CQ Healthbeat: Senators Thursday also urged Medicare officials to do more to stop the up to $60 billion a year that goes out the door in improper payments in the program. "CMS officials are in the process of implementing provisions in the health care overhaul that will broaden auditing efforts aimed at reducing fraud. Congress also sent President Obama additional legislation Wednesday aimed at reducing improper payments in federal agencies. But CMS also needs to finish fixing vulnerabilities found by the Government Accountability Office (GAO) in its system, senators and experts said" (Adams, 7/15).