Sen. Sherrod Brown (D-OH)
House Speaker John Boehner and Minority Leader Nancy Pelosi appear to have a deal
for a permanent solution on the "doc fix," the annual ritual of Congress to override the sustainable growth rate formula for paying doctors for seeing Medicare patients. The two threw in another must-pass funding provision—extending the Children's Health Insurance Program, which is slated to run out of funding later this year. But there's a big problem in the plan, and for good reason. A couple of the bargaining chips Pelosi used to help Boehner secure the deal with his leadership team are not going over well with Senate Democrats. The deal requires higher co-payments for wealthier Medicare beneficiaries—more means testing—and only provides two years of funding for CHIP. Senate Democrats have been pushing for four years of clean funding.
Sen. Ron Wyden (D-Ore.), the ranking member of the Finance Committee, pointedly did not add his name to the SGR repeal bill. "At this point, it is not clear what our House colleagues will ask America's seniors and providers to pay, and the impact that new financial demands will have on them both," Wyden said in a statement explaining his rationale for withholding support. "Every Democrat in the Senate has cosponsored a clean, four-year extension of CHIP. … Yet negotiators in the House seem willing to settle for less, even though extending funding for this widely popular program would amount to pennies on the dollar in terms of the total cost of the House package."
Wyden isn't alone
Sen. Chris Murphy (D-CT) said a fix for children's health insurance should be done for the same length as a fix for Medicare physician payments. […] "I don't understand why we wouldn't ask for CHIP to be extended at the same length as SGR. I want to help our doctors but I also want to make sure kids keep insurance in my state," he said. "Two years is too short for me. I don't want to be back here debating whether or not kids get insurance two years from now."
Senate Minority Whip Dick Durbin (D-IL) told TPM that the two-year extension is "problematic" and said, "I think it should be four."
Progressive Sen. Sherrod Brown (D-OH), the sponsor of a four-year CHIP extension bill which all Democrats have cosponsored, told TPM that Democrats would unite against a two-year deal.
"I think the Democrats are all gonna hang together in the Senate and say we insist on four years," Brown said in an interview.
"How do you fix it for doctors forever and only fix it for children for two years? I mean, that's not the way we ought to do it. We ought to have a minimum four-year clean bill on CHIP at the same time we do the doctors' fix," the senator said.
That's some pretty serious opposition, and they're absolutely right. Boehner is ready to finally deal on the "doc fix" and he's at least so far got his caucus to go along. More importantly, he's already worked with House Democrats to make it happen. That gives every indication that there's room for Democrats, and House Democrats say a four-year plan for CHIP is their preference as well. Pressing for more, a four-year CHIP deal, just makes sense.