WASHINGTON (AP) – Senate leaders drove legislation permanently overhauling how Medicare pays physicians toward final congressional approval Tuesday in a rare bipartisan push to erase an irritant that has dogged lawmakers for years.
The Senate debated the measure less than three weeks after the House passed it by a lopsided 392-37. With Republicans controlling the Senate since January, Majority Leader Mitch McConnell, R-Ky., has been eager to demonstrate his party’s ability to conduct Congress’ business efficiently.
President Barack Obama has promised to sign the bill, which marks a tandem effort by Democrats and Republicans at a time when the two parties are far likelier to block each other’s initiatives. The bill would also block an immediate 21 percent cut in doctors’ fees and provide extra funds for health programs for children and the poor.
Though two-thirds of the measure’s $214 billion, 10-year price tag is financed by simply adding to federal deficits, Republicans were claiming victory in changes the bill makes in Medicare that would have a long-term though modest impact on the huge program’s finances.
About $35 billion over the decade would come from Medicare beneficiaries, mostly by raising the medical and prescription drug premiums paid by some upper-income recipients starting in 2018. Though the affected beneficiaries already pay higher premiums than lower-earning people, Congress seldom increases costs on seniors, fearing retribution come the next Election Day.
The bill would raise another $37 billion by cutting Medicare reimbursements to hospitals and other providers.
Before passage, senators were voting on amendments, three from each party, that seemed sure to lose but let lawmakers demonstrate their disapproval of provisions they opposed.
A Democratic proposal to extend the two years of extra money the measure provided for the popular Children’s Health Insurance Program to four years lost on a 50-50 vote – short of the 60 votes needed to prevail. Conservatives wanted to try forcing Congress to find enough savings to pay for the entire $214 billion measure, instead of financing two-thirds of the bill’s costs by simply making federal deficits larger.
“Honestly it’s my hope that the amendments are not approved, because we need to get this bill down to the president for signature before midnight,” Senate Majority Leader Mitch McConnell, R-Ky., told reporters.
Senators worked with one eye on the clock.
Unless the measure was sent to the White House overnight, the federal agency that handles doctors’ Medicare claims promised to start sending payments reflecting the 21 percent reduction Wednesday. Both parties were eager to avoid complaints from physicians and from Medicare’s elderly patients, whom doctors have often threatened to stop treating if their fees were reduced.
House Speaker John Boehner, R-Ohio, who crafted the compromise with House Minority Leader Nancy Pelosi, D-Calif., warned senators of the impending doctors’ cuts and underscored the futility of trying to amend the bill.
“The House legislation passed with overwhelming bipartisan support, and we do not plan to act again, so we urge the Senate to approve the House-passed bill without delay,” Boehner said in a written statement.
The measure’s completion would erase a problem that has dogged lawmakers for years.
A 1997 law aimed at slowing the growth of Medicare has repeatedly threatened deep cuts in reimbursements to physicians. Congress has blocked 17 of them since 2003.
Republicans and Democrats have wearied of constant lobbying by doctors and their threats to not treat Medicare’s elderly recipients.
The 21 percent cut in doctors’ fees technically took effect April 1. Citing federal law, the federal Centers for Medicare and Medicaid Services stopped processing those claims two weeks ago – in effect giving lawmakers time to complete the legislation.