Updated: Dems Threaten Budget Deal Over ‘Doc-Fix’, Unemployment Insurance

Left balks at proposal to take care of doctors but drop support for unemployed.

Hastings: Calls allegations lies.
National Journal
Clara Ritger
Dec. 11, 2013, 11:04 a.m.

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.

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