Democrats stymied on Medicare physician pay 'fix'

CongressDaily: "Medicare physician payments, unemployment benefits, aid to states and long-stalled tax breaks were all still in limbo Tuesday with no clear path forward." House Democrats are waiting for the Senate to act on the larger bill before considering a separate "doc fix" bill the Senate passed last week.

"House Speaker Nancy Pelosi wants the Senate to pass the worker benefits, aid to states and tax breaks to spur job creation before the House takes up the Medicare fix. But House leaders are coming under heavy pressure from physician groups and AARP, however, after the Senate passed a fully offset 'doc fix' last week." Senate Majority Leader Harry Reid also quickly wants to pass the extenders bill that includes aid to states for Medicaid spending, unemployment benefits and tax breaks. "For now, he and Senate Finance Chairman Max Baucus are trying win over Maine Republican Sens. Olympia Snowe and Susan Collins by making additional cuts to the bill's cost" (Cohn, 6/23).

The Hill: "House Ways and Means Chairman Sander Levin (D-Mich.) said the offsets worked out by the Senate on the Medicare 'doc fix' could be changed once the rest of the tax extenders bill reaches the House," to help pay for that portion of the bill. It could mean that the "doc fix" bill, which would avert a scheduled 21 percent pay cut to doctors, and give them a 2.2 percent raise instead, would have to go back to the Senate before final approval. Technical differences between the House and Senate versions of the legislation remains, Levin said, and could need further refinement (Needham, 6/22).

CQ HealthBeat: There are differences within the House as well: "Majority Leader Steny H. Hoyer and Speaker Nancy Pelosi have staked out different positions about whether the House will follow the Senate and vote on a separate bill to stop a sharp reduction in Medicare payments to physicians." While Pelosi want the Senate to pass the bigger bill, which "includes extensions of tax breaks and benefits for the unemployed,"  yesterday Hoyer "pointedly declined to go that far, saying that there are a lot of things House Democrats want in a jobs bill that are vital, but that doctors who take Medicare patients also have to be paid. ... it's clear that Congress is under the gun to pass jobs and 'doc fix' legislation before its July Fourth recess" (Epstein, 6/22).