The House passed a permanent payment formula fix for Medicare Thursday,
212-33 392-37. That sounds like a totally mundane sentence, but it is a remarkable achievement. The legislation is the result of direct negotiations between House Speaker John Boehner and Minority Leader Nancy Pelosi, and solves a long-standing healthcare policy headache—making sure that physicians are adequately reimbursed for the Medicare patients they treat. Since 1997, when a flawed payment formula was enacted, Congress has been having to pass temporary fixes to keep it from shortchanging doctors, and to keep doctors from dumping their Medicare patients.
Of course, the House passed the bill with basically just hours to spare. The bill has to be passed and signed by the end of this month to avoid the cuts, and Congress will be leaving for recess on Friday. The Senate is tied up with its budget process today and possibly into the early hours of Friday, and passage in the Senate of the doc fix isn't certain. Two issues exist for Senate Democrats. They've been fighting for a four-year extension of the Children's Health Insurance Program, the House bill includes the funding, but only for two years. The second problem is anti-abortion language that has been gratuitously included in the bill, because it also includes funding for community health centers. The typical Hyde amendment restriction on federal funds for abortions has been shoehorned in—needlessly—to the funding language. Pelosi got a concession to have that language specifically sunsetted after two years, but it's still an expansion of Hyde.
It would appear, however, that Senate Democrats' opposition on that front is weakening. Part of that is because President Obama is pushing for its passage. In order for it to pass the Senate and on time, and be able to go straight to the president's desk, it would have to be done by unanimous consent—meaning all Democrats would have to agree. Stay tuned.