On September 17, by a vote of 202 to 213, the House rejected a Democratic motion that would have instructed conferees on HR 1, the Medicare prescription drug entitlement, to push for a final version of the bill expanding Medicare spending in rural areas.
"The House bill offers assistance to health care providers in rural areas with one hand but takes away that assistance with the other hand through a reduction in payments to hospitals," said Rep. Charlie Stenholm (D.-Tex.). "The prescription drug bill will be particularly harmful to rural hospitals," he said, since it supposedly reduces handouts to rural health care facilities.
But Rep. John Shimkus (R.-Ill.) flatly rejected Stenholm's argument that rural areas will be underfunded. "We are not cutting hospital reimbursement," he said, noting that hospital reimbursement actually increases under the bill, although at a slower rate than before. Shimkus cautioned that the Democrats' "budget-busting motion" means the proposed package would "greatly exceed the $400 billion allocated under the budget resolution for Medicare prescription drugs," jeopardizing its chance of ever getting to a final bill.
Democrats generally favored the motion because it would have dumped still more money into the government-run section of the health-care system. Most Democrats in and out of Congress have long believed that a government-controlled Socialist health care system is the political issue with the best chance of returning them to the majority in Congress.
"We know these HMOs and these private plans are not working, for the most part," complained Rep Frank Pallone (D.-N.J.). "If someone tries to get their prescription drugs through an HMO or managed care private plan, in many cases it is not going to be available, and they are not going to have access to it."
Rep. John Tanner (D.-Tenn.) apparently could not accept the fact that rural areas are not dotted with hospitals. "All of the medical technology in the world is not going to help somebody who cannot access the system," he said. "There is no way that one can deny the fact that somebody is going to die needlessly because they do not have a hospital or an emergency medical room within 50, 60 or 70 miles, simply because they live in a rural area."
Of course, no one forces Americans in any state to live 70 miles away from the nearest hospital. Moreover, it is unclear where in the Constitution there is a requirement to subsidize far-flung habitations by building and/or funding hospitals unnecessarily in less-populated areas.
Rep. Ciro Rodriguez (D.-Tex.) feigned shock at the possibility that Congress would increase hospital funding by slightly less than expected, and nearly accused Republicans of stealing from the sick on their deathbeds. "You are taking money from people dying from cancer to try to fill another need," he said. "We are here to tell you there are needs on both sides."
That demagogic argument, however, failed to carry the day.
A "yes" vote was a vote to instruct conferees on H.R. 1-the Medicare prescription drug entitlement-to increase federal Medicare reimbursement of rural hospitals. A "no" vote was a vote against the motion.
| FOR THE MOTION: 202 | AGAINST THE MOTION: 213 |
| REPUBLICANS FOR: 7 Brown-Waite, V. Emerson Fletcher Latham Leach Renzi Wilson (NM) DEMOCRATS FOR: 194 INDEPENDENTS FOR: 1 |
REPUBLICANS AGAINST: 213 Aderholt Akin Bachus Baker Ballenger Barrett (SC) Bartlett (MD) Barton (TX) Bass Beauprez Bereuter Biggert Bilirakis Bishop (UT) Blackburn Blunt Boehlert Boehner Bonilla Bonner Bono Boozman Bradley (NH) Brady (TX) Brown (SC) Burgess Burns Burr Burton (IN) Buyer Calvert Camp Cannon Cantor Capito Castle Chabot Chocola Coble Cole Collins Cox Crane Crenshaw Cubin Culberson Cunningham Davis, Tom Deal (GA) DeLay DeMint Diaz-Balart, L. Diaz-Balart, M. Doolittle Dreier Duncan Dunn Ehlers English Everett Feeney Ferguson Flake Foley Forbes Fossella Franks (AZ) Frelinghuysen Gallegly Garrett (NJ) Gerlach Gibbons Gilchrest Gillmor Gingrey Goode Goodlatte Goss Granger Graves Green (WI) Greenwood Gutknecht Harris Hart Hastings (WA) Hayes Hayworth Hefley Herger Hobson Hoekstra Hostettler Hulshof Hyde Isakson Issa Istook Janklow Jenkins Johnson, Sam Johnson (CT) Johnson (IL) Jones (NC) Keller Kelly Kennedy (MN) King (IA) King (NY) Kingston Kirk Kline Knollenberg Kolbe LaHood LaTourette Lewis (CA) Lewis (KY) Linder LoBiondo Lucas (OK) Manzullo McCotter McCrery McHugh McInnis McKeon Mica Miller, Gary Miller (FL) Miller (MI) Moran (KS) Murphy Musgrave Myrick Nethercutt Neugebauer Ney Northup Norwood Nunes Nussle Ose Otter Oxley Paul Pearce Pence Peterson (PA) Petri Pickering Pitts Platts Pombo Porter Portman Pryce (OH) Putnam Quinn Radanovich Ramstad Regula Rehberg Reynolds Rogers (AL) Rogers (KY) Rogers (MI) Rohrabacher Ros-Lehtinen Royce Ryan (WI) Ryun (KS) Saxton Schrock Sensenbrenner Sessions Shadegg Shaw Shays Sherwood Shimkus Shuster Simmons Simpson Smith (MI) Smith (NJ) Smith (TX) Souder Stearns Sullivan Tancredo Tauzin Taylor (NC) Thomas Thornberry Tiahrt Tiberi Toomey Turner (OH) Upton Vitter Walden (OR) Walsh Wamp Weldon (FL) Weldon (PA) Weller Whitfield Wicker Wilson (SC) Wolf Young (AK) Young (FL) |
NOT VOTING: 19
| REPUBLICANS (8): | DEMOCRATS (11): | INDEPENDENTS (0) |
| Carter Davis, Jo Ann Hensarling Houghton Hunter Osborne Sweeney Terry |
Ballance Deutsch Fattah Gephardt Gordon Israel Lewis (GA) Pastor Payne Ruppersberger Woolsey |
