The House Just Did Something Sneaky to Pass the ‘Doc Fix’

House GOP leaders on Thursday used a voice vote to pass a temporary health care fix, surprising members.

Speaker of the House John Boehner.
National Journal
Elahe Izadi Billy House
March 27, 2014, 8:49 a.m.

Man­euv­er­ing around last-second snags with some back­room in­trigue, House GOP lead­ers used a voice vote Thursday to pass an­oth­er tem­por­ary patch to pre­vent a massive cut to doc­tors’ Medi­care pay­ments.

The de­cision by Re­pub­lic­an lead­ers to cir­cum­vent the planned roll-call vote caught many of their own mem­bers by sur­prise.

“They voiced it? Oh, my God,” ex­claimed Budget Chair­man Paul Ry­an as he walked onto the House floor.

Demo­crats could have op­posed the pro­cess and de­man­ded a roll-call vote be taken, but House Minor­ity Lead­er Nancy Pelosi had giv­en as­sur­ances they wouldn’t do that. At the very least, the use of a voice vote does not provide the pub­lic with a re­cord of who ac­tu­ally sup­por­ted the meas­ure and who op­posed it.

The bill is now ex­pec­ted to be taken up by the Sen­ate.

Doc­tors face a 24 per­cent cut in their Medi­care pay­ments Monday if Con­gress doesn’t act by then. Medi­care’s pay­ment for­mula calls for ever-in­creas­ing cuts, which Con­gress al­ways delays.

The voice vote oc­curred without fan­fare after a series of closed-door meet­ings between House GOP lead­ers and some rank-and-file mem­bers — in­clud­ing mem­bers of the GOP doc­tors’ caucus who op­posed do­ing an­oth­er stop-gap fix but were ap­prised of the voice-vote strategy be­fore it happened.

Doc­tors groups, such as the Amer­ic­an Med­ic­al As­so­ci­ation, have been lob­by­ing for a per­man­ent change in Medi­care’s pay­ment for­mula rather than the tem­por­ary patches Con­gress al­ways passes.

Adding an­oth­er hurdle was that Demo­crats on Thursday morn­ing took to the House floor to de­nounce the tem­por­ary patch in the “doc fix,” or more form­ally, the Sus­tain­able Growth Rate, in fa­vor of a per­man­ent fix.

“It is un­for­tu­nate that we have been put in this po­s­i­tion with less than 48 hours no­tice of what’s in this bill, to do something that all of us knows needs to be done,” House Minor­ity Whip Steny Hoy­er said.

On Wed­nes­day, Speak­er John Boehner had said the deal had been worked out with the Sen­ate to get the meas­ure done.

But with the prob­lems in­tern­ally with­in his own caucus, and the op­pos­i­tion of Demo­crats, the planned pro­cess for passing the bill was scrapped. That ex­ped­ited pro­cess would have re­quired two-thirds of the 432-seat House to vote for it, mean­ing more than 50 of the 199 Demo­crats would have had to go along, even if all Re­pub­lic­ans had sup­por­ted it.

Throughout the closed-door meet­ings, Ma­jor­ity Lead­er Eric Can­tor kept say­ing he re­mained “con­fid­ent” that House ac­tion would still oc­cur on the meas­ure and that “we are work­ing on it.” The ul­ti­mate solu­tion was to hold a voice vote that many mem­bers did not real­ize oc­curred.

Rep. Peter Welch, D-Vt., ex­pressed out­rage at the pro­cess, say­ing, “I didn’t know it happened. We should be vot­ing.”

Rep. Gerry Con­nolly D-Va., who vo­cally voted no, said there wasn’t a re­quest for re­cor­ded vote be­cause “there were con­cerns raised on the Sen­ate side not to do that,” and there was no al­tern­at­ive.

But was this any­thing oth­er than sneaky? “To quote the House of Cards, ‘You might very well say that, but I can­not com­ment that,’ ” Con­nelly said. “I’ve been dy­ing to say that.”

The House passed a $137 bil­lion per­man­ent fix on March 14, which re­lied on sav­ings tied to the re­peal of the Af­ford­able Care Act in­di­vidu­al-in­sur­ance man­date. But that was re­jec­ted by the Demo­crats who lead the Sen­ate, and it faced a pres­id­en­tial veto threat.

The tem­por­ary, smal­ler bill in­cludes spend­ing off­sets from re­duc­tions in oth­er Medi­care spend­ing; also, some of its costs are paid for by re­align­ing se­quester sav­ings set to oc­cur in 2025 to 2024.

Spe­cific­ally, the Pro­tect­ing Ac­cess to Medi­care Act of 2014 would pre­vent the 24 per­cent cut in re­im­burse­ments to doc­tors who treat Medi­care pa­tients by re­pla­cing it on April 1 with ad­op­tion of a 0.5 per­cent up­date through Dec. 1. There would be no per­cent­age changes for the three months fol­low­ing that through April 1, 2015.

Along with ex­tend­ing pay­ments un­der SGR through March of 2015, the bill also in­cludes fund­ing for vari­ous oth­er ex­pir­ing Medi­care pro­vi­sions.

What We're Following See More »
SUFFOLK POLL
New Survey Shows Clinton Up 9 in Pennsylvania
3 hours ago
THE LATEST

If a new poll is to be believed, Hillary Clinton has a big lead in the all-important swing state of Pennsylvania. A new Suffolk University survey shows her ahead of Donald Trump, 50%-41%. In a four-way race, she maintains her nine-point lead, 46%-37%. "Pennsylvania has voted Democratic in the past six presidential elections, going back to Bill Clinton’s first win in 1992. Yet it is a rust belt state that could be in play, as indicated by recent general-election polling showing a close race."

Source:
$500 MILLION PROJECT
Obama Library Heading to Jackson Park in Chicago
3 hours ago
THE DETAILS

"President Barack Obama has chosen Jackson Park, a lakefront park that once hosted the world’s fair on the city’s South Side, for his $500 million presidential library, according to a person familiar with the matter."

Source:
THREE NIGHTS RUNNING
Democrats Beat Republicans in Convention Ratings So Far
4 hours ago
THE DETAILS

Wednesday was the third night in a row that the Democratic convention enjoyed a ratings win over the Republican convention last week. Which might have prompted a fundraising email from Donald Trump exhorting supporters not to watch. "Unless you want to be lied to, belittled, and attacked for your beliefs, don't watch Hillary's DNC speech tonight," the email read. "Instead, help Donald Trump hold her accountable, call out her lies and fight back against her nasty attacks."

Source:
THE QUESTION
How Many VIPs Were the Secret Service Protecting in Philly Last Night?
5 hours ago
THE ANSWER

Seven, according to an official Secret Service tweet.

Source:
‘MOGUL,’ ‘DAREDEVIL’
Candidates’ Code Names Revealed
6 hours ago
WHY WE CARE

The Clintons will retain their Secret Service "code names from the last time they lived in the White House. Hillary Clinton is EVERGREEN and Bill ClintonEAGLE. Donald Trump is MOGUL, according to reports, and Melania Trump MUSE. The vice presidents get code names, too: Mike Pence is HOOSIER—a little on the nose—and his wife HUMMINGBIRD. Tim Kaine is DAREDEVIL, somewhat ambitiously. His wife's? To be determined."

Source:
×