House GOP Considering Costly Medicare Vote

AP Photo/Charles Dharapak
AP Photo/Charles Dharapak
Washington, DC

The clock is ticking. Congress must deal with a key Medicare issue before March 31, and the stage is set for Republican leadership to come away looking even worse in the eyes of its conservative base, if that’s even possible at this point.

At issue is: “patching or ending the Medicare formula, which is known as the sustainable growth rate (SGR).” If lawmakers don’t act, doctors would see “an automatic 22 percent cut in Medicare payments, an outcome both parties want to avoid,” according to The Hill. Congress has failed to find a permanent solution to the problem for 20 years, and short-term fixes have made things worse.

The short-term patches have only driven up the cost to end the formula, with the tab now reaching nearly $200 billion.

House Republican leaders are considering a vote next week on legislation that would abolish cuts to Medicare payments, a policy change that could cost upwards of $174 billion to enact.

Speaker John Boehner (R-Ohio) and his leadership team are quietly coordinating a bill, four sources say, in hopes of ending the decades-long battle over how much doctors and healthcare providers should be paid for treating Medicare patients.

For now, Republicans are keeping a tight lid on their plans. House Majority Leader Kevin McCarthy (R-Calif.) told Republicans in a memo Wednesday that a “doc fix” bill could come up for a vote when they return from this week’s recess. No other details were provided.

Boehner spokesman Michael Steel declined to discuss the leadership’s plans for patching or ending the Medicare formula, which is known as the sustainable growth rate (SGR).

House Republicans aren’t talking – at least not publicly, but Heritage Action for America Communications Director Dan Holler had no problem staking out the conservative position to Breitbart News.

“Far from a gimmick, the annual Medicare ‘doc fix’ process has saved taxpayers $165 billion since 2003. Any permanent solution must be financed with permanent Medicare savings, period,” Holler says. “Americans didn’t hand Republicans a historic House majority to engage in more deficit spending and budget gimmickry. Any deal that only offsets a fraction of the cost, like the one currently being discussed behind closed doors and leaked to the press, is a non-starter for conservatives.”

As the Hill also points out, the Senate may take on the issue separately, and it’s unclear whether the two houses can get together. Meanwhile, Boehner is once again positioned to have to make a choice: build conservative support, or turn away from his own base and allow Minority Leader Nancy Pelosi to play a key role as deal maker:

Should Boehner choose to pursue legislation scrapping the Medicare formula, Democrats and conservatives could both have leverage to negotiate for their votes.

Democrats are anxious to provide an extension of the Children’s Health Insurance Program (CHIP), a coverage option for the poor that will lose funding this year if Congress does not act.

Conservative lawmakers, on the other hand, want to see changes to controversial policies close to the Obama administration, including one related to medical technology known as the ICD-10 rule.

Sen. Ron Wyden (Ore.), the top Democrat on the Senate Finance Committee, has previously proposed abolishing the Medicare formula, and said he is hopeful that GOP leaders are moving in his direction.