Bill To Delay Medicare Physician Payment Cuts Remains Under Debate
On Tuesday, Democratic leaders in the House and Senate continued their efforts to corral enough votes to ensure passage of the so-called "extenders" bill (HR 4213) before Congress adjourns for the Memorial Day recess on Friday, CQ Today reports.
The bill includes extensions to unemployment benefits, including subsidies to help unemployed U.S. residents help purchase coverage through COBRA (Rubin/Schatz, CQ Today, 5/25). It also would delay a 21% cut to Medicare physician reimbursement rates, scheduled to take effect on June 1, and increase physicians' payments by nearly $60 billion over the next three years (California Healthline, 5/21).
House Ways and Means Committee Chair Sander Levin (D-Mich.), who negotiated a compromise on the bill with the Senate Finance Committee, said House Democrats are waiting for the Congressional Budget Office to release final analysis of the package before confirming their support.
In the Senate, Majority Leader Harry Reid (D-Nev.) said the chamber would remain in session until work on the bill had been completed, even though some Democrats and Republicans remain undecided about the bill (CQ Today, 5/25).
Cost, Deficit Increase Remain Key Issues
The bill's cost, reportedly about $200 billion, has become a top concern for many lawmakers, Roll Call reports. Last week, a CBO analysis found that the bill would add nearly $134 billion to the deficit over 10 years (Pierce/Dennis, Roll Call, 5/25).
Although the bill complies with the pay/go rules enacted earlier this year, a large portion of the bill's spending has not been offset because it has been declared as emergency spending or is exempt under the pay/go law.
According to CQ Today, many conservative and first-year Democrats are wary about the cost and the potential increase to the deficit (CQ Today, 5/25).
Other Lawmakers Look at Less Costly Payment Fixes
Senate Finance Committee Chair Kent Conrad (D-N.D.) and other lawmakers are reportedly pushing for a two-year delay to the scheduled physician payment cuts, The Hill's "On the Money" reports. Proponents of the two-year delay say their plan would cost $27 billion less than a three-and-a-half year delay (Heflin/Pecquet, "On the Money," The Hill, 5/25).
Other lawmakers have said that a shorter term fix to Medicare physician payment cuts, such as delaying the scheduled cut through December, would save about $57 billion. Those lawmakers noted that a bipartisan deficit commission will be created by the new health reform law at the end of the year could then decide the future of the payments.
However, other lawmakers and observers have noted that delaying a permanent solution to the payment issue would make it more costly to resolve at a later time (Cohn, CongressDaily, 5/26).
Back-Up Plans Discussed Privately
Democrats are not publicly discussing any back-up plans for the legislation if they are unable to secure enough votes for passage, according to CQ Today.
However, Senate Republicans are preparing for a short-term extension of the bill's health care and unemployment benefits, which could be offset by surplus funding from the 2009 federal economic stimulus package (CQ Today, 5/25).
House Majority Leader Steny Hoyer (D-Md.) has acknowledged that a one-month extension of the expiring programs could be a last resort (CongressDaily, 5/26).This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.