House Seeks Negotiation on Tax Break, ‘Doc Fix’ Bill, but Senate Adjourns

On Tuesday, the House voted 229-193 to set up a conference committee to work out differences with the Senate on legislation to extend a payroll tax break and delay scheduled Medicare physician reimbursement cuts, the AP/Washington Post reports (AP/Washington Post, 12/21).

Background

The Senate on Saturday voted 89-10 on Saturday to approve a two-month version of a House-approved payroll tax break and Medicare "doc fix" measure (HR 3630). Senate leaders initially assumed that the bill would pass easily in the House because it had been endorsed by Senate Minority Leader Mitch McConnell (R-Ky.) and included a provision related to a controversial oil pipeline that Republicans favor.

However, House Speaker John Boehner (R-Ohio) said, "Our members do not want to just punt and do a two-month, short-term fix where we have to come back and do this again."

Although Republicans are calling for conference committee negotiations on the payroll and doc fix proposal, Senate members adjourned for recess after Saturday's vote and are not expected to return until January. Reid on Monday said Senate Democrats would not take part in further negotiations until the House passes the short-term measure (California Healthline, 12/20).

Meanwhile, most House members also left town for recess after Boehner selected lawmakers for the conference committee.

Obama Urges House To Vote on Senate Amendment

President Obama, who said he will remain in Washington, D.C., to settle the issue, appealed to House Republicans to hold a vote on the Senate amendment rather than attempting to form a conference committee. Obama said, "Let's be clear: Right now the bipartisan compromise reached on Saturday is the only viable way to prevent a tax hike on Jan. 1" (Helderman/Kane, Washington Post, 12/21).

He said, "I'm calling on the speaker and the House Republican leadership to bring up the Senate bill for a vote. Give the American people the assurance they need in this holiday season" (Epstein, Politico, 12/20).

Political Positioning

With only 11 days until the tax break expires and Medicare payment cuts kick in, Democrats are betting Republicans will concede and pass the short-term measure out of fear of being blamed by U.S. residents and physicians.

However, some House Republicans believe they are not as politically vulnerable as Democrats assume. Rep. Jack Kingston (R-Ga.) said, "I think when I ... make the case that (House Minority Leader) Nancy Pelosi (D-Calif.) won't appoint conferees and (Sen. Majority Leader) Harry Reid (D-Nev.) has left town, I think I'm going to be fine politically."

Analysts note that even if the Senate agreed to return for a conference committee, conferees would not be likely to reach a consensus within the short time frame before the payroll tax break and current doc fix expire (Min Kim/Budoff Brown, Politico, 12/20).

Lawmakers Consider Standalone Doc Fix

Rep. Phil Gingrey (R-Ga.), an obstetrician and co-chair of the GOP Doctors Caucus, said House leaders should not accept any proposal without a two-year doc fix, but he acknowledged that if lawmakers cannot reach an agreement, they might consider a standalone bill to address the issue during the next session, Modern Healthcare reports.

He said, "If they cannot come to an agreement, ... there will be a separate bill on the doctors as soon after we come back as possible -- maybe the first bill that we bring up." He noted that the bill would be retroactive to fix Medicare payments dating back to the Jan. 1, 2012. He added, "I hope we don't have to come to that," noting that the two-year fix "is the least we can do to give certainty to the medical providers if they're going to stay in the Medicare program" (Zigmond, Modern Healthcare, 12/20).

Physician Groups Aggravated by Congress

Physician groups have criticized Congress for failing to reach an agreement on a new doc fix proposal, CQ HealthBeat reports.

The American Academy of Family Physicians said that the "congressional failure deeply angers family physicians." Glen Stream, president of AAFP, said, "Regardless of whether Congress will retroactively make up this devastating loss of practice income next year, federal lawmakers' failure to act will cause grave disruption in physician practices."

American Medical Association President Peter Carmel said, "Congress has again failed to fulfill its responsibilities. It is shameful that patients and physicians are the collateral damage; the citizens of this country deserve better."

Meanwhile, senior advocacy group AARP also criticized lawmakers. AARP Senior Vice President Joyce Rogers said, "For too many years, Congress has furthered the anxiety of people in Medicare with an annual ritual of gamesmanship with Medicare physician reimbursement rates." Rogers added, "Our members have a clear message for Congress: Don't cut our doctors' Medicare payments" (Reichard, CQ HealthBeat, 12/20).