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Scott Olson

House GOP caves on ‘doc fix’

Just two weeks ago, House Republicans launched their latest extortion plot, which seemed destined for failure. This morning, the House GOP gave up.
At issue is a must-pass Medicare bill – popularly known as the “doc fix” – that establishes the rates at which physicians are paid for seeing patients. If Congress fails to act by the end of the month, doctors would face a massive pay cut that would risk destabilizing the system.
It led House Republicans to launch a new hostage scheme: they’d agree to the usual doc fix, but only if Democrats agreed to a five-year delay in the Affordable Care Act’s individual mandate (a policy Republicans used to support until 2010).
When the Congressional Budget Office said the delay would cause health insurance premiums to go up and lead 13 million Americans to go without insurance, GOP lawmakers said they didn’t care – they had a demand and they expected their ransom to be paid, regardless of merit.
Democrats, of course, dismissed the ploy as ridiculous, sat back, and waited for Republicans to cave. That happened this morning.
House Republican leaders are preparing to pass a new “doc fix” bill that would prevent a 24 percent cut in reimbursements to physicians under Medicare.
Republicans plan to bring up the bill this week to prevent the cut, which is set to happen on April 1.
According to the 121-page bill posted on the House Clerk’s website late Tuesday night, the House will pass a year-long extension, through the end of March 2015. The bill also extends several related healthcare measures until the end of March 2015.
As you might have guessed, the demands for a five-year delay in the individual mandate are gone. The House is expected to vote tomorrow, and the Senate will reportedly follow soon after.
And while the predictable resolution is reassuring – it seemed pretty obvious Republicans wouldn’t follow through on their threats, and just took the hostage to see what might happen – it does make one wonder why GOP lawmakers scramble to make sure physicians get paid, but ignore the unemployed.
Indeed, Roll Call’s David Hawkings suggested the other day that Republicans are inviting “one of the most tin-eared headlines of this campaign year: Congress bails out doctors again but still spurns the unemployed.”
Through a confluence of circumstances, the two measures likely to get the most attention at the Capitol for the next several days would each cost about $10 billion, and both include budgetary offsets making them deficit-neutral.
But only one is likely to ever get cleared: Legislation giving physicians significant, if not-quite-total relief, lasting until after the election, from the 24 percent cut in their Medicare fees that is set to take effect next month.
While lawmakers remain unable to agree on a means to pay for a permanent fix in the outdated payment formula, there’s a strong bipartisan sentiment in favor of shielding doctors from a sudden drop in their income. […]
The other bill would extend federal insurance benefits for the long-term jobless for another five months, while also paying claims retroactively since the program lapsed at the end of December.
By all appearances, medical professionals have political capital, so congressional Republicans aren’t willing to risk their ire.
The unemployed, however, lack political capital in the GOP’s eyes, so there’s no real concern about passing extended benefits, regardless of the human and economic costs.