Washington Digest: House approves ‘doc fix’

WASHINGTON — House Republicans and Democrats came together last week to resolve a decade-old deficiency in the way doctors are reimbursed by Medicare.

Since 2002, the physician reimbursement formula used by Medicare has called for steep reductions, which Congress has overridden year by year, fearing that if it were enacted, fewer doctors would accept Medicare patients.

Congress, however, struggled to find a permanent solution to the problem as Democrats and Republicans sparred over how to pay for the “doc fix.” Physician payment rates are scheduled to be cut by nearly 21 percent on Wednesday.

House Speaker John Boehner, R-Ohio, and House Minority Leader Nancy Pelosi, D-Calif., formed a compromise that would replace the old formula with one they said provides predictability and would reward doctors for quality care over quantity.

The cost of holding reimbursement payments at current levels would be paid for largely through increased premiums paid by wealthy Medicare beneficiaries.

Pelosi said the new formula would transition Medicare away from a volume-based system.

“With this legislation, we give America’s seniors confidence that they will be able to see the doctors they need and the doctors they like, liberating them and their families from the shadow of needless, annual crises,” she said.

Rep. Paul Ryan, R-Wis., said the bill would change how Medicare pays doctors for the better.

“Right now, you get paid for every single treatment you perform — no matter how effective you are. So what we say to doctors is, ‘From now on, we’re going to reward quality work. Do a good job, make people better, keep them out of the hospital, and you’ll get paid more.’ I think we all can agree that’s better than just paying for the amount of care,” Ryan said.

The House approved the bill, 392-37. Reps. Mark Amodei, R-Nev., Cresent Hardy, R-Nev., Joe Heck, R-Nev., and Dina Titus, D-Nev., voted for it.

SENATE OKs BUDGET BLUEPRINT

The Senate narrowly approved a Republican budget resolution that calls for $5.1 trillion in spending cuts over the next decade in a bid to bring the budget into balance.

The budget resolution is nonbinding but serves as a road map for annual appropriations bills that fund government agencies. It also reflects the priorities of the Republican majority, including the repeal of the Affordable Care Act. The resolution drew hundreds of amendments, some substantial, others designed mostly to score partisan points.

Republicans, who largely supported the budget, claimed it would eliminate deficit spending within a decade without raising taxes.

“The important first steps we have taken this week will help deliver a government that is more accountable, which is absolutely essential for strong job growth and job creation. This budget will help every American who wants to find a good-paying job and a fulfilling career,” said Sen. Michael Enzi, R-Wyo., the Senate Budget Committee chairman.

Democrats opposed the budget resolution, saying it would protect the wealthy at the expense of the needy. Repeal of the Affordable Care Act, they said, would leave more than 16 million without health insurance and 11 million more would lose coverage through a proposed $400 billion cut to Medicaid.

“When they get up there and say this budget does not include any tax increases, they are right,” Sen. Bernie Sanders, I-Vt., said. “But what they are really saying is … We will make it harder for kids to go to college, we will throw people off of health insurance, but we will not ask the rich and the powerful to pay more in taxes.”

The Senate voted 52-46 in favor of the budget resolution. Sen. Dean Heller, R-Nev., voted for it; Sen. Harry Reid, D-Nev., voted against it.

BUDGET RESOLUTION CLEARS HOUSE

The House approved its own budget resolution using a rarely used procedure that pitted several alternatives against one another. In the end, a Republican proposal won out that, like the Senate version, would balance the budget over the next decade through a repeal of the Affordable Care Act and other spending cuts.

Republicans praised the document, saying that responsible budgeting will lead to a stronger economy.

“What is so important about this budget is not just the fact that we get back to balance within 10 years,” Rep. Steve Scalise, R-La., said. “But it is all the underly­ing policies, the great reforms that have been so desperately needed by Washington for so long, actually confronting challenges facing our country in a way that puts us on a path to get the economy moving again.”

Democrats complained that the Republican plan would not balance the budget and would unfairly target the needy through program cuts rather than asking the wealthy to pay more in taxes.

“Why is it they don’t cut one single special-interest tax break to help reduce the deficit? Not one,” said Rep. Chris Van Hollen, D-Md. “That is $1.4 trillion a year. This is more than we spend on Social Security every year. It is more than we spend on Medicare and Medicaid combined every year. They don’t cut a single one of those.”

The House budget resolution was approved on a final vote of 228-199. Amodei, Hardy and Heck voted for it; Titus voted against it.

Contact Peter Urban at purban@reviewjournal.com or at 202-783-1760.