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U.S. Senate Minority Leader Mitch McConnell (R-KY) arrives to speak to the media about healthcare on Capitol Hill in Washington October 29, 2013. REUTERS/Yuri Gripas
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.

Originally posted to Joan McCarter on Tue Apr 01, 2014 at 09:26 AM PDT.

Also republished by Daily Kos.

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Comment Preferences

  •  Tip Jar (30+ / 0-)

    "The NSA’s capability at any time could be turned around on the American people, and no American would have any privacy left, such is the capability to monitor everything. [...] There would be no place to hide."--Frank Church

    by Joan McCarter on Tue Apr 01, 2014 at 09:26:17 AM PDT

  •  Typical Washington (7+ / 0-)

    Neither side wants a permanent fix, because they both love to assume the cuts will expire in their budgets to make them look better all the while knowing they will pass a yearly fix.

    It's part of the annual kabuki dance and is one area where both sides are totally in this together.

  •  GOP CYA tactics (2+ / 0-)
    Recommended by:
    radarlady, Matt Z
    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.

    Warning - some snark may be above‽ (-9.50; -7.03)‽ eState4Column5©2013 "I’m not the strapping young Muslim socialist that I used to be" - Barack Obama 04/27/2013 (@eState4Column5).

    by annieli on Tue Apr 01, 2014 at 09:35:27 AM PDT

  •  Collins & Cornyn actually supported something good (2+ / 0-)
    Recommended by:
    radarlady, JML9999

    "No man has a good enough memory to be a successful liar." Abraham Lincoln

    by appledown on Tue Apr 01, 2014 at 09:35:50 AM PDT

  •  What? Is this an April Fool joke? (2+ / 0-)
    Recommended by:
    radarlady, Matt Z

    Vote #1 was this:

    clear the first hurdle to put the measure on a path to passage.
    Vote #2 was this:
    voted in favor of the deal itself.
    Everybody who voted "for" the first also is listed as having voted "for" the second.  Where's the flip-flop?

    “Texas is a so-called red state, but you’ve got 10 million Democrats here in Texas. And …, there are a whole lot of people here in Texas who need us, and who need us to fight for them.” President Obama

    by Catte Nappe on Tue Apr 01, 2014 at 09:59:29 AM PDT

  •  Why does the "Doc-fix" come up year after year? (3+ / 0-)
    Recommended by:
    radarlady, OldDragon, alypse1

    Nothing happens in Washington without a reason. This is true of the "Doc-fix" dilemma that, despite good government practice or even basic logic, requires repeated Congressional action. Why does this continue to happen and who benefits from it?

    Think about the unholy alliance between Washington lobbyists and Congress. If the lobbyists don't have a bill or some governmental action needed by their corporate masters to  influence Congress, they have nothing to justify their expensive existence. If Congress doesn't present a problem for the lobbyist to work on, they don't receive the campaign money that keeps them in office.  

    To tie this to the reoccurring Doc-fix problem, since it is an annual event, the lobbyist are kept busy, money continues to flow from their corporate paymasters and Congress fills its campaign treasuries. Everybody is happy except the American taxpayer sucker who gets stuck with the bill.

  •  An interesting side piece is that (2+ / 0-)
    Recommended by:
    Aunt Pat, Wednesday Bizzare

    ICD-10 is delayed one more year.

    "Harass us, because we really do pay attention. Look at who's on the ballot, and vote for the candidate you agree with the most. The next time, you get better choices." - Barney Frank

    by anonevent on Tue Apr 01, 2014 at 07:11:23 PM PDT

    •  In the battle of the AMA vs Big Insurance (0+ / 0-)

      and the American Hospital Assn, the AMA wins this round.

      This is a costly delay for all involved.

      Election Day is Nov 4th, 2014 It's time for the Undo button on the 2010 Election.

      by bear83 on Tue Apr 01, 2014 at 08:09:17 PM PDT

      [ Parent ]

  •  Changing their position by changing their position (0+ / 0-)

    I want 1 less Tiny Coffin, Why Don't You? Support The President's Gun Violence Plan.

    by JML9999 on Tue Apr 01, 2014 at 07:33:58 PM PDT

  •  Holy FSM, what a stupid face. I know Mitch is (0+ / 0-)

    crazy like a fox, but what a cosmic joke. On all of us.

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