House Takes Meaningless Vote on ‘Doc Fix’

Despite the House’s approval Friday of a long fought-for solution to Medicare physicians’ pay, the bill is doomed to die because it’s tied to a delay of Obamacare’s individual mandate.

Rep. Michael Burgess, R-Texas
National Journal
Clara Ritger
Add to Briefcase
Clara Ritger
March 14, 2014, 7:17 a.m.

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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