House Democrats don't want to pass a "doc fix" without extending unemployment insurance, and they're threatening to sink the budget deal over it.
"If we're going to provide reimbursement to physicians, and I favor that, I think we need to be sure we don't leave 1.3 million people out in the cold," said Rep. Sander Levin of Michigan at the House Rules Committee meeting Wednesday afternoon.
The proposed doc fix would delay for three months a 20 percent cut in reimbursements to physicians who provide services for Medicare beneficiaries, as instituted by the Sustainable Growth Rate formula. Congress had tried for a bipartisan, bicameral permanent fix in 2013, but with two committees set to mark up the legislation Thursday, will not complete it until the beginning of the year.
But by reopening the deal to include a fix to physician reimbursement, the budget pact's shepherds open themselves to a host of requests to accommodate other priorities.
"I personally am conflicted as to whether I will vote on this" budget deal, said Rep. Alcee Hastings, D-Fla. "I can't leave that many people by the wayside unless I have a better understanding about what's happening here."
Unemployment insurance payments to approximately 1.3 million people will expire Dec. 28 without congressional action. Democrats hope to forestall that by proposing a three-month extension of the benefits along with the three-month doc-fix proposal.
"The failure to act on UI and having to do so on [physician reimbursement] puts the entire bill at risk," Levin said. "It's not a cut of 25 percent—it's 100 percent elimination of their benefits. It's historically high."
The committee met Wednesday to mark up the Medicare measure along with the Bipartisan Budget Act of 2013, the deal hammered out by Rep. Paul Ryan, R-Wis., and Sen. Patty Murray, D-Wash. and announced late Tuesday.
Update 7 p.m.: The three-month SGR proposal was reported out of committee on a vote of 9-3.