News & Events

House votes to ease Medicare cuts to doctors

Move would add $200b to the deficit

By Erica Werner, Associated Press  |  November 20, 2009

WASHINGTON – The Democratic-controlled House voted yesterday to add more than $200 billion to the deficit to prevent steep Medicare payment cuts to doctors, a move Republicans denounced as a political payoff to physicians for backing President Obama’s health care overhaul.

The measure, approved on a near party-line vote of 243 to 183, is a top priority for the American Medical Association. “This is nothing more than a repayment to the American Medical Association for endorsing the larger health care bill that was on the floor several weeks ago,’’ said Representative Joe Barton, a Texas Republican.

“This is not a question of payoff to anybody,’’ retorted majority leader Steny Hoyer, a Maryland Democrat. “It’s the right thing to do.’’

Doctors are facing a 21 percent reduction in Medicare reimbursement rates in January unless Congress acts first, the result of a flawed funding formula that lawmakers have had to step in nearly annually to block in recent years. The bill attempts a permanent fix by restructuring the payments to factor in how much doctors spend on various services, among other changes.

Past votes on the issue have been largely bipartisan, but this year the doctor payment issue has become a proxy for the larger health overhaul debate. Only one Republican voted “yes’’ yesterday, Representative Michael Burgess of Texas, an obstetrician. Eleven Democrats voted “no.’’

Despite intense lobbying by the AMA, the doctor payment legislation failed in the Senate last month in an embarrassing defeat, with moderate Democrats concerned about the deficit joining Republicans to bring it down.

That leaves its future uncertain even though the rate cuts loom in less than two months.

James Rohack, AMA president, called on the Senate to act, saying the legislation is “an essential element of comprehensive health reform.’’

He also dismissed GOP arguments that Democrats were paying off the AMA, saying, “This is about patients, not partisan politics.’’

The Obama administration has sought a permanent solution to avoid the uncertainty of one-year payment patches, and House Democrats obliged by including it in their 10-year health overhaul bill.

But before passing that bill this month they took out the doctor payment measure, in part to keep the cost of the overall bill low enough to meet Obama’s target price tag.

“The reason it was separated, I would have to admit, was purely political,’’ Representative Pete Stark, Democrat of California, said. “We had to abide by the president’s request that we not exceed certain costs.’’

Although House Democrats have vowed not to pass legislation that’s not paid for, the doctor payment bill is one of several items they have exempted from that rule, and the Congressional Budget Office says it would increase the deficit by $210 billion over 10 years. Republicans devoted much of yesterday’s debate to complaining about that, but Democrats said it was Republicans’ fault for setting up the problematic payment formula in the first place.