Ensign splits with Nevada delegation on Medicare bill

By Lisa Mascaro

Tuesday, July 15, 2008 | 5:09 p.m.

WASHINGTON -- As the House and Senate voted this afternoon to override President Bush’s veto of a popular Medicare bill that would halt pay cuts for physicians, all of Nevada’s lawmakers except Sen. John Ensign voted to pass the legislation into law.

Both chambers picked up more Republican support on the override than when the bills initially passed.

AARP and doctors organizations lobbied fiercely to avoid the 10 percent pay cut, saying it could force physicians to stop seeing Medicare patients. Nevada has a growing senior population, with more than 320,000 Medicare recipients.

The threat of a pay cut arises every year as an unintended consequence of Medicare reimbursement formulas, but Congress has traditionally been able to prevent it. Both Republicans and Democrats wanted to avoid the pay cut again this year, but the problem proved thornier when Democrats sought to balance the books by trimming payments to Medicare Advantage, a program run by private insurers. Bush and some Republicans opposed cutting the private program they tout as an alternative to Medicare, even as Democrats say it is more expensive to run.

Ensign wanted to avoid the doctors’ pay-cut, but also opposed trims to the privately run program, which serves about 30 percent of Nevada’s Medicare patients.

AARP’s Nevada office put lawmakers on notice it would be tracking today’s votes and sharing the results with its 331,000 members in the state and 40 million nationwide.

House Republican Reps. Jon Porter and Dean Heller had previously voted in favor of the bill, as did Democratic Rep. Shelley Berkley. All three voted to today override Bush, as did Senate Majority Leader Harry Reid.

The House passed the legislation 383-41, with support from 153 Republicans -- picking up 24 more than last month. The Senate passed it 70-26, with four more Republicans.

Democratic Sen. Edward Kennedy, who dramatically returned to the chamber last week from his illness to help pass the bill, did not vote. Also not voting were the presidential candidates, Democratic Sen. Barack Obama, who previously supported the bill, and Republican Sen. John McCain, who did not vote last week.