Of the three issues, the so-called "doc fix" is the least controversial. The "doc fix" is the shorthand used to describe the nearly annual bill Congress passes to override another law they passed, the Sustainable Growth Rate (SGR) formula, which was enacted in 1996 to try to keep Medicare costs under control. Almost every year since it has been overridden by Congress because it doesn't actually work. If it's not fixed this year, providers will be hit with a nearly 30 percent cut in their reimbursements.
The Democrats have a relatively simple idea for paying for this fix basically forever. Their plan is to pay for a full repeal of it with the more than half a trillion dollars in savings from the Iraq and Afghanistan drawdowns. Up until now Republicans have been insisting that was nothing but an accounting gimmick and not real money. They would much prefer to pay for the fix by enacting deep cuts in other health care spending, notably hacking away at the Affordable Care Act.
But they've taken some heat over that from providers over the intransigence on this one. In addition to that pressure, it is possible that it's dawned on them that picking these fights over proposals that actually help people is making them less popular generally. At any rate, they seem to be coming around to the Democrats' idea.
Rep. Phil Gingrey (R-GA), the co-chairman of the GOP Doctors Caucus, which leadership usually defers to on this issue, last month slammed the war savings offset as “funny money” and a “Ponzi scheme.” But Tuesday after the State of the Union, he was singing a different tune. [...]
“You might say that using the overseas contingency fund is a little bit of smoke in mirrors, but quite honestly, the SGR is smoke in mirrors,” he argued. “Let’s trade one flawed system for the other, if you will. Let’s bring it back to zero, and start fresh, and do the right thing.”
Gingrey says House leadership has essentially given the issue over to the GOP Doctors Caucus to decide, so Gingrey's attitude will likely seal the deal. Giving up on trying to force other health care cuts in this bill means one less knock-down drag-out fight for Democrats and, almost unbelievably, Congress finally resolving an issue they've been putting off dealing with for years.