House passes bipartisan 'doc fix' Medicare bill

Erin Kelly
House Speaker John Boehner, R-Ohio, negotiated a bipartisan agreement with and Minority Leader Nancy Pelosi, D-Calif.

WASHINGTON — The House approved a bipartisan bill Thursday that would prevent a 21% cut in payments on April 1 to doctors who treat Medicare patients.

The vote was 392-37 in favor.

The legislation still must be approved by the Senate, where its passage is less certain. Senators are expected to take up the bill Friday.

The bill would repeal the current Medicare payment formula for doctors and replace it with one that would increase payments to doctors by one-half of 1% every year through 2019. After that, doctors would receive bonuses or penalties depending on performance scores from the government. Their scores would be based on the value of the care they provide rather than on the volume of patients they see.

The legislation would end the annual scramble by lawmakers to pass a temporary patch to keep the payments from plummeting. Congress has been struggling with what both sides call a "flawed formula" since lawmakers enacted it in 1997.

The non-partisan Congressional Budget Office estimated that the bill would increase the deficit by $141 billion over 11 years. But the CBO also said the bill spends $900 million less than if Congress simply froze Medicare payment rates for doctors over that same period.

The rare bipartisan agreement was negotiated by House Speaker John Boehner, R-Ohio, and Minority Leader Nancy Pelosi, D-Calif.

"This is what we can accomplish when we focus on finding common ground," Boehner said. Pelosi said she hoped the vote "will be a model for things to come."

"Don't look now, but we are actually governing," said Rep. Renee Ellmers, R-N.C., as she spoke in favor of the bill on the House floor.

The legislation also includes a two-year renewal of the Children's Health Insurance Program, which provides low-cost health coverage to children whose parents earn too much to qualify for Medicaid but are still struggling financially.

It also provides $7 billion for two years to fund more than 1,000 community health centers, which provide health care for low-income Americans throughout the country. That funding is tied to the Hyde amendment, which prevents any of the money from being used to provide abortions except in cases of rape, incest, or when the life of the mother is in danger.

That abortion provision, which is opposed by groups that support abortion rights, threatened at one point to derail the "doc fix" deal. However, Pelosi, an abortion rights supporter, said the abortion language in the bill is already in place for community health centers and will expire after two years. She convinced her fellow House Democrats to support the bill.

The White House came out in support of the bill Wednesday. However, some Senate Democrats have said they aren't sure they can vote for a bill that contains the abortion language.

The head of the American Medical Association urged the Senate to pass the bill before senators leave for a two-week recess that begins Saturday.

"The Senate must act ... to stop a looming 21% cut in Medicare reimbursements that will force reductions in access to health care for America's seniors, military personnel and their families," said Robert Wah, a doctor and president of the group . "The time is now to finally lay this destructive issue to rest and act immediately to build a stable and sustainable Medicare program that our nation's patients and physicians need and deserve."

But another group, the Physicians for a National Health Care Program, said the bill would undermine traditional Medicare coverage and move toward privatization of the program. The group's leaders said the bill would increase burdensome paperwork for doctors, discouraging them from taking Medicare patients. They said it also would undermine popular support for Medicare by increasing premiums for higher-income senior citizens.

"In the fervor to finally rid us of the flawed ... model of setting Medicare payment rates, Congress is about to pass legislation that includes ill-advised, misguided and detrimental policies that could cause irreparable harm to our traditional Medicare program," said Don McCanne, a doctor and senior health policy fellow for the non-profit group.

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