WASHINGTON — America’s doctors can finally rest easy: Not only has Congress ensured they will be paid in full for the services they render to Medicare patients, it has ended the yearly ritual putting that in doubt.
The Senate voted 92-8 Tuesday night to approve a long-term “doc fix,” as the legislation adjusting Medicare fees has long been known, less than three hours before federal officials would have reduced payments to health-care providers by 21 percent. President Barack Obama signed the bill, which also extends the federal Children’s Health Insurance Program and support for community health centers, before a midnight deadline.
Despite the last-minute nature of the vote, it was lauded by Hill leaders as a bipartisan triumph for both removing a yearly headache from the legislative calendar and for implementing modest reforms to Medicare. Those include incentives for doctors to deliver higher quality care rather than a higher quantity of care, as well as premium hikes for the wealthiest Medicare recipients.
“Instead of kicking this important Medicare payment issue down the road again, a strong bipartisan majority in Congress voted to finally solve the problem and ensure that seniors on Medicare don’t lose access to their doctors,” Majority Leader Mitch McConnell, R-Ky., said in a statement.
Sen. Ron Wyden, D-Ore., ranking member of the Senate Finance Committee, said the vote was “a milestone for the Medicare program” for unraveling a “common-sense-defying” reimbursement system.
Obama, in a statement, called it “a milestone for physicians, and for the seniors and people with disabilities who rely on Medicare for their health care needs” and said it was consistent with his own health care policy.
For Republicans, the final vote was a new occasion for political victory laps, with McConnell calling it “another reminder of a new Republican Congress that’s back to work.” But it could not have happened without support from top Democratic leaders.
The deal was forged last month in the House, in a bargain struck by Speaker John Boehner, R-Ohio, and Minority Leader Nancy Pelosi , D-Calif., to eliminate the yearly “doc fix” votes while implementing some cost-cutting reforms to Medicare and extending the children’s insurance program.
The bill passed the House 392 to 37 on March 26. The Senate did not act on the bill before leaving the next day for a two-week recess.
The “doc fix” has been necessitated by a 1997 legislative provision known as the Sustainable Growth Rate, which mandated that Medicare fees could not exceed the growth in the overall U.S. economy. But as actual health-care costs have far outstripped the fee hikes allowed by the 1997 legislation, Congress has been forced to step in on a yearly basis to reset the rates or risk the possibility that many health-care providers would stop treating Medicare recipients.
Before the final Senate vote Tuesday, senators rejected six amendments, the adoption of any of which would have sent the bill back to the House, busting the midnight deadline. The Centers for Medicare &Medicaid Services said earlier this month that it would begin processing cut-rate payments to doctors starting Wednesday.
The bill passed over the objections of the Senate’s most conservative senators, who pushed colleagues to pay for the $141 billion in net spending that the Congressional Budget Office estimates the bill will create over the next decade. Sen. Mike Lee , R-Utah, accused his Republican colleagues of hypocrisy for touting a budget resolution that will balance the federal budget by 2025 while passing a Medicare bill that will undermine that goal.
Sen. Ted Cruz, R-Texas, a presidential candidate, said in a statement Tuesday that any deal ending the “doc fix” should be “fully paid for and include significant and structural reforms to Medicare that provide seniors more power and control over their health care.”
An amendment offered by Sen. John Cornyn, R-Texas, would have offset the additional spending by repealing the health-care individual mandate – the cornerstone of President Obama’s Affordable Care Act. That measure went down along party lines in a vote requiring a 60-vote majority, with no Democrats or independents joining the Senate’s 54 Republicans.
Republicans, meanwhile, banded together to defeat Democratic amendments that would have doubled the children’s health insurance extension from two years to four, eliminated abortion restrictions in the bill and beefed up funding for women’s health, and eliminated a cap on Medicare coverage for physical therapy.
Eight Republicans opposed final passage: Cruz, Lee, David Perdue of Georgia, Marco Rubio of Florida, Ben Sasse of Nebraska, Richard Shelby and Jeff Sessions of Alabama and Tim Scott of South Carolina.
While Cruz and Rubio opposed the bill, a third presidential hopeful, ophthalmologist Rand Paul, R-Ky., supported it.
Talk to us
> Give us your news tips.
> Send us a letter to the editor.
> More Herald contact information.
