Conservatives are pressing GOP congressional leaders to scrap or alter the Medicare doctor payments deal they struck with Democrats last month, insisting that Congress at least find a way to pay for all of the reforms so taxpayers don’t get stuck with higher bills or debt later this decade.
The deal, reached by House Speaker John A. Boehner and House Minority Leader Nancy Pelosi, breezed through the lower chamber last month, but hit a hiccup in the Senate, where both conservatives and liberals found reasons to pump the brakes.
Congress returns Monday from a two-week vacation, facing an April 15 deadline for fixing the formula for paying doctors who treat Medicare patients. That’s left hold-out conservatives feeling pressure from their leaders to get on board, and from right-wing pressure groups to hold firm in their opposition to the compromise that President Obama has praised.
Under the deal struck by House leaders, the annual cuts to doctors’ payments, called for in a 1997 balanced budget law and amounting to a 21 percent trim this year, would be nixed. In exchange, some wealthy seniors would pay more for being in Medicare.
The compromise would end the annual exercise where Congress waives the cuts mandated in its own law.
The changes would cost taxpayers a net $141 billion over the next decade — spurring some of the opposition from conservatives who said it made a mockery of the balanced budgets both House and Senate Republicans passed just before their Easter break.
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“This is what brings this Congress in disrepute,” Sen. Jeff Sessions, Alabama Republican, told colleagues before they skipped town.
Conservatives’ latest proposal to tweak the plan, floated on Capitol Hill this week, would force the bill to be subject to a 2010 budget law requiring that new spending be offset by other spending cuts or tax increases.
It wouldn’t mean the cuts would have to be found immediately, but would require that they be paid for some time in the future.
“What that would do is buy you time to find the offsets you need,” said Marc Goldwein, vice president of the nonpartisan Committee for a Responsible Federal Budget.
Time is a factor. Unless the Senate acts by Tuesday, the administration says it will have to begin following the current law that would impose the 21 percent pay cut to doctors.
Doctors’ lobby groups are incensed at the possibility that their payments may be cut, and they warn some physicians may refuse to treat Medicare patients if the situation isn’t fixed. That threat has pushed Congress to patch the law 17 times before.
SEE ALSO: Brief bipartisanship period over Medicare ‘doc fix’ breaks down
But Mr. Boehner and Mrs. Pelosi argued since the law was always having to be circumvented, often causing a major political firestorm, it made sense to fix the law once and for all. They powered the bill through their chamber, and are now counting on Senate Majority Leader Mitch McConnell, Kentucky Republican, to do the same in his chamber.
Don Stewart, a spokesman for Mr. McConnell, said senators “are discussing the path forward,” and that “the leader said he expects the bill will be done quickly.”
Senate Finance Chairman Orrin G. Hatch, Utah Republican, has said “anyone who waits around for the perfect bill better be prepared to wait for a very, very long time.”
Opponents, however, hope the deal has soured for lawmakers during the two weeks they’ve been away from Washington.
“We would hope that the message they got is to find a different way to do this,” said Doug Sachtleben, spokesman at the Club for Growth.
• Tom Howell Jr. can be reached at thowell@washingtontimes.com.
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