Democratic leaders in Congress continued to push a 10-year, roughly $174 billion package of Medicare provisions and extensions to safety net health programs they want passed before the Memorial Day recess even though an intra-party rift over cost could prove troublesome.
Lawmakers wrestle with cost of doc payment fix
“We should have the ‘jobs’ bill over here tomorrow,” Senate Majority Leader Harry Reid (D-Nev.) told reporters, referencing the bill that also includes a 3½-year “fix” for Medicare physician payments.
Under that timeline, the House would have to pass the bill on Wednesday—a tall but not impossible order even though a bloc of fiscally conservative Democrats has balked at the amount of spending that would not have to be offset by savings elsewhere in the federal budget.
The Congressional Budget Office said the bill would add about $134 billion to the national debt, a large chunk of which would come from the patch on the sustainable growth-rate formula. That provision alone would add $64.6 billion to the deficit.
House Majority Leader Steny Hoyer (D-Md.) said he wants a permanent fix to the SGR—something along the lines of what the House passed late last year—but added that such a measure wouldn’t pass muster in the Senate.
“The Senate did not take it up, so it’s obvious they don’t have the votes there to fix it permanently,” he said. “So we will have to see what we can do, and we’re working on that right now.”
Lawmakers could ultimately scale back the legislative package while keeping the SGR provision that’s currently included in it. Under that measure, physicians would see a pay increase of 1.3% through the balance of 2010 and another 1% in 2011. After that, the SGR baseline would be set at zero even though doctors are likely to see some level of update under a restructured formula for 2013 and 2014.
When asked if Democrats are considering refiguring that measure or finding a way to pay for it, Sen. Claire McCaskill (D-Mo.) said, “Both.”
Meanwhile, President Barack Obama pressed Senate Republicans to back the package during an afternoon lunch. Though a small part of a larger conversation, several senators said the topic of health reform came up. “We’re just way beyond a point where we can go forward with legislation that’s going to cost that much money and not pay for it,” Sen. George LeMieux (R-Fla.) said after emerging from the lunch.
Also, the bill extends the COBRA premium subsidy for the unemployed through the end of the year and continues a higher federal share of Medicaid that’s paid to the states.
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