Fresh from a two-week vacation, Congress is back and already struggling to meet a pair of looming deadlines, with no prospect for a budget and little progress on breaking a stalemate on Medicare spending.
If the Senate can’t pass a Medicare deal by Wednesday morning, doctors who treat Medicare patients will face a 21 percent cut in their federal reimbursements.
Wednesday is also the deadline set in law for Congress to approve the budget for the next year’s spending, but instead of finishing up, GOP lawmakers said they’ll only take the first steps by officially appointing House and Senate negotiators to hammer out an agreement.
“It’s my intention to get this budget done by the end of this month,” House Majority Leader Kevin McCarthy said.
While Congress typically blows past the budget deadline — the resolution sets limits for actual spending bills — missing the Medicare cutoff would have a real-world impact on medical practices’ cash flow, even if Congress can make them whole later on.
Doctors’ bills submitted on April 1 will have to begin being processed on April 15, and the reimbursement will be 21 percent lower thanks to automatic cuts written into a 1997 budget law that Congress has, until now, always patched over.
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A permanent fix sailed through the House last month but ran into opposition in the Senate.
With just one full legislative day to work before the deadline, Senate Majority Leader Mitch McConnell, Kentucky Republican, didn’t say how he would like to proceed Tuesday.
Meanwhile, his troops battled over the bill.
“This is a good bill, and it’s coming at the right time,” Senate Finance Chairman Orrin Hatch, Utah Republican, said Monday.
He said senators need to accept the legislation as-is and pass it without amendments. But GOP deficit hawks want to offset the bill’s price tag with savings down the road.
Democrats said they’d pursue a few changes of their own. They want to fund the Children’s Health Insurance Program for four more years instead of the two-year extension included in the bill.
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Democrats also want to boost women’s health through one of several funding avenues and remove Medicare’s annual caps on physical, speech and occupational therapies.
“We don’t want to amend this bill to death. We want three simple amendments,” Senate Minority Leader Harry Reid, Nevada Democrat, said.
The legislation earned 392 votes in the House and would permanently nix cuts to doctor’s payments, thus heading off an annual headache for lawmakers who have always temporarily papered over the cuts but have never found the money to pay for a permanent repeal.
The legislation would pay for a partial repeal by requiring some wealthy seniors to pay more for Medicare — but it still would leave a $141 billion deficit.
Sen. Mike Lee, Utah Republican, wants Congress to apply budget rules to the bill, which would mean all of the $141 billion would eventually have to be paid for by tax increases or spending cuts elsewhere.
“I think we need to have that vote, and I think it needs to pass,” Sen. Jeff Sessions, Alabama Republican, said of Mr. Lee’s proposal.
Mr. Sessions later said there was “a reluctance” on the part of Senate Republican leaders to allow amendments.
GOP leaders want to act swiftly on the package, arguing Congress is on the cusp of a milestone that will save money in the long run, and leave lawmakers with one less recurring headache over the regular patches.
Mr. McCarthy, California Republican, said “taking away these cliffs” will be one of his top priorities as majority leader.
Mr. McCarthy also said he expects it will be fairly simply to reach an accord on a budget between the House and Senate, who both passed blueprints that erase deficits within a decade.
“I do not see much difference between the two,” Mr. McCarthy said.
Democrats, though, have vowed a fight, saying they don’t see much good in either budget.
“Not only is the Republican budget immoral, it is bad economic policy,” said Sen. Bernie Sanders, Vermont independent who leads Democrats on the Budget Committee.
• Tom Howell Jr. can be reached at thowell@washingtontimes.com.
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