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
Billy House and Elahe Izadi
Add to Briefcase
Billy House Elahe Izadi
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 »
THE PLAN ALL ALONG?
Manchin Drops Objections, Clearing Way for Spending Deal
12 hours ago
THE LATEST

"The Senate standstill over a stopgap spending bill appeared headed toward a resolution on Friday night. Senators who were holding up the measure said votes are expected later in the evening. West Virginia Democrat Joe Manchin had raised objections to the continuing resolution because it did not include a full year's extension of retired coal miners' health benefits," but Manchin "said he and other coal state Democrats agreed with Senate Democratic leaders during a caucus meeting Thursday that they would not block the continuing resolution, but rather use the shutdown threat as a way to highlight the health care and pension needs of the miners."

Source:
UNCLEAR WHAT CAUSED CHANGE OF HEART
Giuliani Out of Running For State
14 hours ago
BREAKING

Donald Trump transition team announced Friday afternoon that top supporter Rudy Giuliani has taken himself out of the running to be in Trump's cabinet, though CNN previously reported that it was Trump who informed the former New York City mayor that he would not be receiving a slot. While the field had seemingly been narrowed last week, it appears to be wide open once again, with ExxonMobil CEO Rex Tillerson the current favorite.

Source:
ALSO VICE-CHAIR OF TRUMP’S TRANSITION TEAM
Trump Taps Rep. McMorris Rodgers for Interior Secretary
19 hours ago
BREAKING
SHUTDOWN LOOMING
House Approves Spending Bill
1 days ago
BREAKING

The House has completed it's business for 2016 by passing a spending bill which will keep the government funded through April 28. The final vote tally was 326-96. The bill's standing in the Senate is a bit tenuous at the moment, as a trio of Democratic Senators have pledged to block the bill unless coal miners get a permanent extension on retirement and health benefits. The government runs out of money on Friday night.

HEADS TO OBAMA
Senate Approves Defense Bill
1 days ago
THE LATEST

The Senate passed the National Defense Authorization Act today, sending the $618 billion measure to President Obama. The president vetoed the defense authorization bill a year ago, but both houses could override his disapproval this time around.

Source:
×
×

Welcome to National Journal!

You are currently accessing National Journal from IP access. Please login to access this feature. If you have any questions, please contact your Dedicated Advisor.

Login