Could it really be? Could one of the perennial Republican hostages actually be solved, by Republicans?
Roll Call reports that Republicans
are potentially to a permanent doc fix deal. The doc fix is an annual bill Congress passes to prevent something called the Sustainable Growth Rate—a formula Congress adopted in 1997 to set Medicare payments—from actually kicking in and cutting those payments dramatically. Now Congress is actually talking about a permanent fix, and meaning it.
As Congress approaches another deadline, lawmakers seemed hopeful Monday evening they could do something increasingly rare: take off their can-kicking shoes and make a deal.
Aides told CQ Roll Call that Speaker John A. Boehner was set to give the Republican Conference an update on the “bipartisan discussions” regarding the Sustainable Growth Rate during the GOP’s weekly meeting Tuesday morning. And the prospect of reaching an elusive long-term deal on the payment formula for doctors and medical professionals accepting Medicare was looking better and better.
In another unusual move, House leadership Nancy Pelosi and John Boehner have been
negotiating together to find this solution, having brought a few of their leadership teams into the negotiations in the past week to start trying to solidify the detail. Those
details—another surprise—include
not offsetting the entire cost of the repeal, something that Republicans have rejected repeatedly previously.
While talks continue in the House and some objections have surfaced, the contours of the deal that emerged on Friday continue to tenuously hold, according to lobbyists and staffers tracking the issue. The $215 billion package would include permanent repeal of Medicare's sustainable growth-rate formula, a two-year extension of the Children's Health Insurance Program and a two-year extension of a package of healthcare-related tax and spending provisions.
"Cautiously optimistic is the way that I would describe my feeling about the situation," said Rep. Renee Ellmers (R-N.C.), who sits on the Energy & Commerce Committee. "I am confident that it can be done."
Some of what's not going to fly so well with Democrats include added means testing in Medicare, kicking in for beneficiaries with incomes well above $100,000. But a final fix for this—taking away one of the things Republicans have
always used as a hostage in budget negotiations—might sway Democrats to agree. It might also set Republicans firmly against the agreement. But it's worth keeping an eye on, because there are
five potential budget crises coming this year (every year) and it's possible, just possible, that Boehner and enough of his caucus have reached the breaking point on brinksmanship. The odds are against this actually working, but it's kind of stunning that they're even trying.