THE House of Representatives approved a $214 billion bill on Thursday, March 26 that permanently blocks physician Medicare cuts, moving Congress closer to resolving a problem that has plagued both parties for years.
The lopsided 392-37 vote shifted pressure onto the Senate, where its prospects have brightened as Democrats have muffled their criticism and President Barack Obama has embraced the bill. However, some conservatives are recoiling at the unclear measure.
Thursday’s House vote came on a package that bore victories for Republicans and Democrats alike, and was negotiated by the chamber’s two chief rivals, House Speaker John Boehner and Minority Leader Nancy Pelosi.
The united vote contrasted vividly with the usual partisan duels that hamper most congressional efforts on federal budget, healthcare, and other major policies.
The vote even gave House GOP leaders a respite from the large uprisings they frequently face from tea party conservatives. Last month, a measure preventing a Homeland Security Department shutdown (slated for Feb. 27) was narrowly avoided.
The Medicare bill was backed by Republicans 212-33, while Democrats voted 180-4.
The bill contains funds for health care programs for children and low-income families, provisions Democrats are calling victories. Republicans also won long-term strengthening of Medicare’s finances, including cost increases for higher-income recipients.
With such incentives, House members more accustomed to gridlock found themselves with little to argue about.
“I just want to say to the American people, don’t look now but we’re actually governing,” said Rep. Renee Ellmers (R-N.C.).
Time plays a factor into the quick, bipartisan vote, with Congressional members gearing for a weeklong spring break, and physicians treating Medicare patients facing a 21 percent fee cut on April 1 unless lawmakers act. If the Senate does not give final approval before recessing, the federal agency which sends doctors their checks could face delays in processing.
Underscoring dissatisfaction by some conservatives, Sen. Ben Sasse (R-Neb.) said the bill would deepen budget deficits and do little to strengthen Medicare.
“We should use this crisis as an occasion to be talking about real entitlement reform,” he said.
Physician groups have long warned that the constant procession of threatened slashes in their Medicare fees could mean fewer doctors available to treat the program’s elderly recipients.
After the House vote, the American Medical Association and other health organizations urged the Senate to quickly approve the measure, claiming it would have “a real and lasting impact” on patients and doctors’ practices. AARP, the seniors’ lobby which has criticized the high costs the measure would bring for Medicare beneficiaries, conceded it would pass the House, but said it would “continue to work with Congress to improve the bill.”
“This is what we can accomplish when we’re focused on finding common ground,” said Boehner, adding that Republicans would continue pushing to tighten the finances of Medicare and other costly federal benefit programs. “It shouldn’t take another two decades to do it.”
“It was my honor to work with Speaker Boehner on this important issue, to do what we came here to do—to legislate,” said Pelosi.
The main goal of the doctor bill is replacing a 1997 budget-cutting law that tied doctors’ Medicare fees to overall economic growth. With medical costs growing, that formula has threatened deep reimbursement cuts which lawmakers have blocked 17 times since 2002. Most agree to end this ritual.
The nonpartisan Congressional Budget Office said the measure’s costs totaled $214 billion over the next decade. To pay for it, $141 billion would come from deeper budget cuts, while the rest would be divided between Medicare recipients—mostly bigger monthly premiums for the highest earners—and providers like nursing homes and hospitals.
Republicans pushed for increased premiums for upper-income Medicare beneficiaries, saying they would help restrain the yearly $500-billion costing program and open the door for future overhauls.
The measure also has money for diabetes research, abstinence education, rural hospitals and schools, and for training health professionals serving in low-income areas.
(With reports from Associated Press)
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(Las Vegas April 2-8, 2015 Sec. A pg.4)