It was a game of Republican musical chairs in the Senate Monday, as Congress once again completed the must-pass "doc fix" just under the wire, hours before Medicare reimbursement rates to doctors were to be cut by 24 percent. The doc fix, a perennial and sometimes even biannual ritual in Congress, is a temporary resetting of what's called the SGR, the sustainable growth rate, for reimbursements. It was first passed in 1997, tying the rate of growth in Medicare payments to the GDP. But it was deeply flawed, for one thing not taking into account overhead costs for physicians. Every year Congress talks about repealing it and coming up with some kind of real formula, and every year they fail. Sen. Ron Wyden
had one this time around. It failed.
The fix really is must-pass though, because the deep cuts it makes in reimbursements mean that doctors wouldn't be able to afford to keep taking Medicare patients. So two key constituencies—the medical community and seniors—have to go through this annual freak-out. It always passes, but always with much angst among members that they can't come up with a permanent fix. The same thing happened this time, with Republicans actually voting all over the map to show their opposition, but at the same time make sure that thing passed.
During the first vote Monday, GOP Sens. Roy Blunt of Missouri, Richard M. Burr of North Carolina, Susan Collins of Maine, John Cornyn of Texas, Orrin G. Hatch of Utah, Dean Heller of Nevada, Mark S. Kirk of Illinois, Mitch McConnell of Kentucky, Lisa Murkowski of Alaska and David Vitter of Louisiana joined the effort to waive the budget rules and clear the first hurdle to put the measure on a path to passage.
But it was a different mix of Republicans who supported the “doc fix” bill just minutes after and helped send it to President Barack Obama’s desk.
Kelly Ayotte of New Hampshire, Blunt, Burr, Saxby Chambliss of Georgia, Thad Cochran of Mississippi, Collins, Cornyn, Hatch, Heller, John Hoeven of North Dakota, Johnny Isakson of Georgia, Kirk, McConnell, Murkowski, Vitter and Roger Wicker of Mississippi voted in favor of the deal itself.
That way, they could make sure it passed, because it had to and they'd catch hell if it didn't, but could distance themselves from it. They voted for it before they voted against it. Or something. Just more stupid Republican legislative tricks.