A long-term fix for Medicare's physicians' pay problem got the House's stamp of approval Friday, but the bill is going nowhere because it also delays Obamacare's individual mandate.
The House passed, 238-181, the measure that would repeal and replace the flawed SGR formula that institutes annual payment cuts to doctors who provide services to Medicare beneficiaries.
But the cost of the bill is offset by a five-year delay of the Affordable Care Act's individual mandate, and the White House has already issued a statement that the president would veto it if it arrives on his desk.
Without the individual mandate, fewer Americans would sign up for Medicaid or private insurance on the health law's exchanges. In total, 13 million people would forgo insurance, according to Congressional Budget Office estimates, resulting in lower federal expenditures on the Medicaid program and the premium tax credits designed to make private coverage more affordable.
"There is no reason for the House Republicans to put the doctor community through this charade again," said Rep. Earl Blumenauer, D-Ore., in an impassioned floor speech. "We had, in fact, been making remarkable progress on a bipartisan solution. Instead the Republicans have hijacked those negotiations and made it so bad that even the American Medical Association rejects it."
In a letter to Congress earlier this week, the powerful doctors' lobby expressed "profound disappointment that a strong bipartisan, bicameral effort to repeal the Medicare sustainable growth rate (SGR) has become a victim of partisan approaches to resolve budgetary issues."
Friday's vote comes after negotiations on a realistic pay-for have stalled movement on the bill. Republicans argued on the floor that Democrats had no other suggestion about how to pay for the fix.
"We have at the end of the month a cliff where our providers under Medicare are looking at a 24 percent cut," said Rep. Tom Reed, R-N.Y. "The other side is engaging in political theatre. The other side … believes that we should continue to do what we do in Washington and pass policy without paying for it."
Congress has until March 31 to come to an agreement—or pass another temporary "doc fix"—to avert an automatic cut to doctors' pay.
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