Controversy, lobbying surround Reid's Medicare payment 'fix' plan

Oct 19 2009

Some news outlets are looking ahead to a vote expected next week "fixing" a planned cut in Medicare payments to physicians.

The Hill: "Physicians and their lobbyists are preparing to come out in force next week to push for Senate passage of a $247 billion bill that would achieve the long-sought objective of reforming an obscure Medicare policy that threatens their pay every year. The American Medical Association (AMA) is at the forefront of the campaign and is a huge part of the reason Senate Majority Leader Harry Reid (D-Nev.) is bringing the Medicare bill to the floor without budgetary offsets just a week before he plans to open debate on a broad healthcare reform bill."

"The physician lobby is desperate for the payments issue to be addressed. For most of this decade, the AMA and other groups have had to fight every year to get Congress to block cuts in their Medicare fees that are the result of a payment system widely regarded as flawed. In 2010, payments would be slashed by 21 percent without legislation" (Young, 10/17).

In a larger piece on Medicare and health reform, Christian Science Monitor provided background on the issue: "In 1997, Congress voted to establish a 'sustainable growth rate' (SGR) for Medicare in a bid to rein in federal deficits. But the annual cuts in the growth of payments to doctors serving Medicare patients proved so unpopular that many physicians stopped accepting Medicare patients. Congress has come up with funds to 'fix' the cuts every year since 2003. On Monday, Senate majority leader Harry Reid launches a bid to end the SGR with a key procedural floor vote. ... The vote sets up a tough choice for moderate Democrats, especially coming just days after the US Treasury announced a record $1.4 trillion deficit for FY 2009. It also sets up a clash with House Democrats, who are committed to pay-as-you-go rules requiring offsets for new spending or tax cuts. But if successful, it moves $245 billion in costs off the table, as Democrats work out a plan to pay for healthcare reform" (Chaddock, 10/17).

CQ HealthBeat: "A spokesman for Minority Leader Mitch McConnell of Kentucky said Republicans have agreed to proceed to the bill only if Democrats agree to allow some amendments. ... Republicans could still raise a budget point of order against the measure, because its cost — estimated at more than $240 billion over the next 10 years — is not offset with any spending decreases or revenue increases. Republicans could also filibuster a vote on passing the bill. Either move would require 60 votes to overcome. But a Democratic leadership aide speculated that Republicans are struggling to decide how to address the measure" (Wayne, 10/16).

Roll Call: "Facing stiff bipartisan resistance ... Reid has decided to scrap a planned Monday vote to begin consideration of the plan. ... Originally included in the massive health care reform bill making its way through Congress, Reid carved out the costly Medicare payment plan and announced a cloture vote Thursday afternoon.
But Republicans are opposed to it over a lack of offsets for the bill. Several Democrats like Budget Chairman Kent Conrad (D-N.D.) and Evan Bayh (D-Ind.) have also signaled their opposition. (Stanton and Brady, 10/16).

The Hill in a separate story: "Senate Democrats' attempt to reform Medicare doctor payments separately of their larger healthcare bill is little more than a 'budget gimmick,' Sen. Orrin Hatch (R-Utah) said Friday. ... Hatch contends that the Senate effort is motivated in part by Democrats' desire to pare down the price tag of the Finance Committee's healthcare proposal, estimated to cost more $800 billion over 10 years. By passing a more permanent payment reform before Congress tackles its other healthcare concerns, Hatch explained, Democrats can create the impression their latter, bigger effort has less of a deficit footprint. Nevertheless, Hatch admitted Friday some 'doc fix' must pass in order to ensure doctors 'don't quit taking Medicare patients'" (Romm, 10/17)