Senate Does Not Pass Bill To Delay Medicare Pay Cuts to Physicians
A House-passed bill (HR 6331) that would delay a 10.6% reduction to Medicare physician fees failed by one vote to receive the 60 votes in the Senate required to gain cloture on Thursday, CongressDaily reports.
The House passed the measure by a veto-proof margin earlier this week.
The bill is similar to a measure (S 3101) proposed by Senate Finance Committee Chair Max Baucus (D-Mont.) that also failed to receive enough votes to invoke cloture (Edney, CongressDaily, 6/27).
The final vote on Thursday was 58-40; however, Senate Majority Leader Harry Reid (D-Nev.) changed his vote to no to ensure he could reintroduce the bill under procedural rules (Armstrong , CQ Today, 6/26).
Sen. Judd Gregg (R-N.H.) offered a 30-day extension of the current pay level, but Reid objected (Edney, CongressDaily, 6/26).
According to CongressDaily, "Democrats hoped the impending deadline and unexpected overwhelming support in the House would put enough heat on GOP senators to support cutting off debate" (CongressDaily, 6/27).
Presumptive Republican presidential nominee Sen. John McCain (Ariz.) and Sen. Edward Kennedy (D-Mass.) were not present for the vote.
Presumptive Democratic presidential nominee Sen. Barack Obama (Ill.) voted for cloture on the measure.
McCain was in Ohio campaigning during the vote and Kennedy is undergoing cancer treatments after recently having a brain tumor removed.
According to the New York Times' "The Caucus", "McCain's absence made it likely that Democrats would seek to hold him at least partly responsible for the outcome."
"The Caucus" reports that a McCain spokesperson said he had no immediate comment (Herszenhorn, "The Caucus," New York Times, 6/26).
On Thursday, Reid told senators to clear their calendars for the weekend and prepare for another cloture vote on Sunday, according to a spokesperson for the lawmaker.
According to CongressDaily, Senate Republicans have objected to bringing the legislation to the floor on Friday.
Meanwhile, Reid said that he cannot file for cloture until midnight due to other legislative efforts (CongressDaily, 6/26). A Sunday vote could push final action on the bill into next week (Armstrong , CQ Today, 6/26).
Baucus said that the House measure is the Senate's only option to avert the fee cut before the Fourth of July recess because the House has already left for recess.
"There is no alternative," Baucus said, adding, "This is the only train in the station" (Armstrong , CQ Today, 6/26).
Reid said that the Senate is "going to finish Medicare" before it adjourns for the recess (Armstrong , CQ Today, 6/26).
The White House on Thursday again threatened to veto the measure because it makes cuts to indirect medical education payments and imposes limitations on so-called private fee-for-service plans under Medicare Advantage.
The Bush administration said that the bill would "reduce access, benefits and choices for many of the approximately 2.25 million beneficiaries who have chosen to enroll in" the plans (Armstrong , CQ Today, 6/26).
The measure would cut about $14 billion over five years from payments to some plans under MA (Lueck, Wall Street Journal, 6/27).
Although Finance Committee ranking member Chuck Grassley (R-Iowa) voted against cloture, he said, "I personally think the White House has drawn lines in the sand that are unreasonable."
Baucus and Grassley reached a tentative agreement on a compromise bill earlier this week, but it was abandoned in the Senate after the House approved its measure by a veto-proof margin. According to CongressDaily, "The compromise would have avoided a promised veto of the House-passed measure" (CongressDaily, 6/27).
Republicans "were upset" that they did not have the option to vote on the compromise legislation, according to CQ Today (Armstrong , CQ Today, 6/26).
However, CQ Today reports that "there may not be enough time" for the bill to pass the Senate and the House before the recess.
CQ Today reports that Reid "could ultimately ... accept Gregg's plan for a 30-day extension of the current doctor payment rates" (Armstrong , CQ Today, 6/26).
Congress also has the option of returning after the recess and passing a bill that would retroactively restore the physician payment levels and block the cut.
However, such a move "will likely create an administrative headache" and "ha[s] long been seen as an undesirable outcome," according to CQ Today (Armstrong , CQ Today, 6/26).