House OKs Democrats' Medicare 'Doc Fix' Over GOP Objections

The House on Thursday approved the so-called "doc fix," a $210 billion plan to keep doctors who treat Medicare patients from experiencing severe cuts in their annual federal reimbursements.

The plan passed by a vote of 243-183 with only one Republican voting for it. But the bill is essentially dead on arrival since the Senate failed to pass its version last month. The House vote and public opposition from Republicans amounted to little more than political maneuvering as both sides sought to win the support of doctors in the health care reform debate.

The "doctor fix" would be paid by more federal borrowing for Medicare, a program already steep in debt. The plan would also add to the federal deficit, which hit an all-time high of $1.42 trillion in the fiscal year that ended Sept. 30.

Earlier in the day, Republican leaders denounced the House Democrats' version.

"Bringing an unpaid 'doc fix' to the floor is the height of irresponsibility," House Minority Leader John Boehner, R-Ohio, said at a news conference ahead of the vote.

Medicare physicians are facing a 21 percent cut in reimbursements next year and another roughly 5 percent cut for each of the next several years, according to the 2009 Medicare Trustees report.

Supporters of the "doc fix" say that a long-term fix is needed to provide certainty to doctors, and their patients, many who fear the cuts and therefore refuse to treat Medicare patients.

But Senate Democratic leaders failed last month to garner enough support for their $247 billion version of the "doc fix." The Senate blocked the plan by a vote of 47-52, with 13 Democrats joining all Republicans in opposition.

Rep. Mike Pence, chairman of the House Republican Conference, issued a direct warning to President Obama about the "doc fix."

"Mr. President, we have news for you," the Indiana Republican said. "People are looking at the deficit and this is adding to a lack of confidence in this economy."

Rep. Paul Broun, R-Ga., issued a statement to doctors.

"The message to doctors is this is not going to fix your problem," he said. "You should know that doctors are going to have a tough time seeing you if this bill is passed into law."

The proposal would replace a formula from the 1997 Balanced Budget Act designed to hold down Medicare costs by setting yearly and cumulative spending targets. If actual spending exceeds the target for a given year, reimbursement rates for doctors are lowered the next year. Expenditures have exceeded projections for the past seven years and Congress has passed legislation to override the fix all seven years.

The measure originally was expected to be part of Obama's sweeping health care reform legislation. But separating it will allow Democrats to prevent the measure from pushing health reform legislation over the $900 billion ceiling set by Obama. The president asserts that the 10-year plan will be paid in large part through savings in Medicare.

Republicans on the House Ways and Means Committee sent a letter to the president of the American Medical Association, which supports the "doc fix," expressing support for tackling the looming cuts but voicing concerns over the Democrats' plan.

"I support the intent of the legislation to stop the physician payment cut, but not only does the Democrats' bill not permanently solve the problem as some have claimed, it massively increases the deficit," Rep. Dave Camp, the top Republican on the House Ways and Means Committee, said in a written statement.

"Republicans have a fully paid for policy that will ensure doctors receive fair compensation without adding to our already oversized national debt."

Rep. Wally Herger, the top Republican on the House Health Subcommittee, added, "The Democrats' proposed 'fix' is really a shell game designed to mask the true cost of their proposed government takeover of health care, and it would add, by one estimate, nearly $2 trillion to Medicare's long-term unfunded liabilities -- which are already nearly $40 trillion."