There were all sorts of strange things occurring yesterday when the Senate Finance Committee held a hearing on initiatives for Medicare-Medicaid dual eligibles, and they may be pretty revealing about both duals and Washington politics. For one thing, the power in the hearing room went off and on for extended periods at least three times, prompting numerous snide comments about congressional inability to get anything done. But more significantly, the hearing showed again that it is Republicans who are the strongest supporters of the Obama administration’s duals initiatives.
Duals initiatives represent an area “in which we can achieve bipartisan agreement,” unlike other things in Washington these days, said the committee’s ranking minority member, Sen. Orrin Hatch (R-Utah). He also went out of his way to praise the director of the CMS duals office, Melanie Bella, for her “pragmatic” approach and the quick pace of getting the big duals demonstration ready. Referring to the current climate in Washington, Hatch later added, “I don’t want to continue to praise you for fear it might hurt you.”
Contrast that with the comments of Sen. Jay Rockefeller (D-W. Va.), who was partly responsible for getting the duals demonstration provision included in the health reform law but now has become a critic of its scope and speed. One problem with enrolling as many duals in a state in the demonstration as the duals office seems to be intending, said Rockefeller, is when that happens, it ceases to be a demonstration and instead “it’s the inevitable formulation of policy.”
What do you think is the likely outcome of these upside-down assessments of the duals program? Will it get derailed because of Democrats’ misgivings? Should it? Or can Washington perhaps make duals “the start of a beautiful relationship”?
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