The Senate had until midnight on Tuesday to prevent a 21 percent cut to physician payments in the Medicare program, and they skated nearly up to that deadline, ensuring that no amendments would be made to the legislation because that would have required the House take it up again, and the deadline would have been missed. But they
passed it, 92-8, rejecting six amendments.
The bill would repeal the current Medicare payment formula for doctors and replace it with one that would increase payments to doctors by one-half of 1% every year through 2019. After that, doctors would receive bonuses or penalties depending on performance scores from the government. Their scores would be based on the value of the care they provide rather than on the volume of patients they see.
Medicare recipients with incomes of more than $85,000 a year would be required to pay higher Medicare Part B premiums starting in 2018.
Among the presidential candidates voting, Sen. Rand Paul (R-KY) was a yes, Sens. Marco Rubio (R-FL) and Ted Cruz (R-TX) were noes. Because freedom. Or deficits. Same thing in the Republican brain.
There's much good and some bad here. The best is that a hostage has been permanently released by the Republicans. The "doc fix" has been voted on something like 17 times since 2003, and in the past several years has been one of those must-pass bills (must-pass because Medicare doctors kept threatening to stop taking Medicare patients if they were hit with the big payment cuts the old formula kicked in) that Republicans used in their various brinksmanship games. That's gone, and the annual and sometimes bi-annual freak-out that physicians' groups and senior groups have had to go through is now over. Also good is two years of Children's Health Insurance Program funding granted rather painlessly, though the four-year extension Senate Democrats were pushing for (it was one of their amendments) would have been better.
Not so good, the anti-abortion Hyde amendment language has wormed its way into a new place, in community health center funding included in the bill. The federal funding prohibition on abortions already applied here, and community health centers don't provide abortions anyway, so it's redundant and unnecessary but is now ensconced in one more place. Also not so good—it continues the sneaking means-testing for Medicare, making it more okay for wealthier seniors to be hit harder in their premium payments. All part of the Republican plan to keep eroding the popularity of the program, one senior at a time.
President Obama will quickly sign it and the Congress will quickly devolve back into a body that doesn't do much of anything other than pointless, political-point-making grandstanding.