Sen. Durbin Supports Expansion of Competitive Bidding

Editor’s Note: CRE has long warned that federal officials seek to expand competitive bidding.

From: Roll Call

Durbin: ‘Put Everything on the Table’

Sen. Richard J. Durbin on Tuesday laid out his “progressive” vision for deficit reduction, pegged largely to ideas generated by a 2010 bipartisan deficit reduction commission, and he said negotiators likely will target $4 trillion in total savings as part of a deal to avert the fiscal cliff.

Durbin — a member of the president’s commission on deficit reduction as well as the bipartisan “gang of six” — expressed optimism that lawmakers could come to a deal. But the No. 2 Democrat in the Senate said that a debt limit increase would have to be part of any agreement.

“Put everything on the table,” Durbin said, departing from his prepared remarks but not from their intent. While Durbin said he thinks all topics, including entitlements, should be addressed, his prepared remarks made clear that Social Security and Medicare overhauls should be done separate from any fiscal cliff deal.

In an address at the liberal think tank Center for American Progress, Durbin provided substantial extemporaneous commentary and skirted mentions of the specific entitlement changes written in the original text of his speech, though he told reporters afterward he endorsed everything in the original prepared remarks.

Democrats have been largely reluctant to list out any specific changes to Medicare and Medicaid they would support as part of a broader deficit reduction package, as their caucuses are divided on how to deal with programs so central to their political constituencies.

Durbin’s prepared remarks said Democrats would not be open to repealing the health care overhaul. In a question-and-answer period after his speech, he said his vote for the law was the “most important” he ever cast, but he would be open to “tweaks” if appropriate.

“Expand payment reforms in Obamacare,” the prepared remarks said as one way to achieve more savings. “Doctors should be paid for the quality of the service not the quantity of the tests they order. This will incentivize better care and lower costs, and we have already seen the results in pilot programs across the country.”

Other entitlement reforms Durbin endorsed in the prepared text were: negotiating better prices for Medicaid prescription drugs, increasing the use of “effective” generic drugs for Medicaid and Medicare patients, and expanding competitive bidding for “durable” medical equipment. Durbin projected that such changes could save about $144 billion.

Durbin also said he would have “trouble” raising the Medicare eligibility age.

“We need to take an honest look at Medicare,” Durbin said off-the-cuff. “I happen to think that the Paul Ryan approach was not the right approach to say the least. … I think it was unworkable.”

Durbin said entitlement changes fit into the “progressive” agenda because Democrats’ interest should be in saving programs that clearly will become insolvent without change.

Another “progressive” proposal cited by Durbin was the expansion of an infrastructure bank as part of a deficit reduction deal to spur economic growth and create jobs.

Many of his ideas presented Tuesday were cribbed from the 2010 Bowles-Simpson deficit reduction report, which failed to garner enough bipartisan support for recommendation but has become the foundations for other groups, such as the gang of six and the defunct supercommittee. The report has come back into the political mainstream in recent days, with top Republicans such as Speaker John A. Boehner endorsing recent ideas from the Democratic principal of the talks, former Clinton chief of staff Erskine Bowles.

Durbin also emphasized that the $1.2 trillion in cuts enacted by the 2011 Budget Control Act, half of which come from defense discretionary spending, is a “good down payment” in the current talks and that further cuts to domestic discretionary spending should not be significant, as many funds for programs assisting the poor already have been shrunk or eliminated by the original deal.

He said if a necessary debt ceiling increase is not part of a fiscal cliff deal, “We’re not going to find ourselves celebrating one big party” once an agreement is reached and said that it should be part of any fiscal bargain.