In an act of bipartisanship seldom witnessed in the halls of Congress, the US House of Representatives overwhelmingly passed a bill that would permanently replace the formula for reimbursing doctors who treat Medicare patients.
The so-called “doc fix” bill sailed to final passage with a vote of 392-37, a shocking margin in the context of institutional gridlock that has defined Washington this millennium. The deal was crafted by the House speaker, John Boehner, and House minority leader, Nancy Pelosi, opponents who urged their counterparts in the Senate to “expeditiously” pass the legislation.
The bill puts an end to the near-annual exercise that has plagued Congress for more than a decade – a ritual that originated with a 1997 law that sought to rein in Medicare spending by linking pay increases for providers to economic growth. But faced with rising healthcare costs and potentially drastic pay cuts to doctors, Congress responded by issuing temporary patches to the formula rather than imposing the fee limits.
Meanwhile, a permanent fix evaded lawmakers who have mostly used entitlement reform to score political points. The House-passed bill offers a rare breakthrough by repealing the “sustainable growth rate” formula for Medicare reimbursements with incremental 0.5% pay increases for doctors each year through 2019.
The bill, Pelosi said, represents a way to “remove this fight from the calendar in a way that is transformative and will lower cost for Medicare”, while Boehner heralded it as a “true bipartisan agreement”.
“This will be the first real entitlement reform that we’ve seen in nearly two decades, and that’s a big win for the American people,” Boehner told reporters on Capitol Hill.
The White House threw its support behind the bill, which also includes two years of funding for a government program that provides children from low-income families with health insurance.
“I’ve got my pen ready to sign a good, bipartisan bill – which would be really exciting,” Barack Obama said on Wednesday. “I love when Congress passes bipartisan bills that I can sign. It’s very encouraging.”
The bill now heads to the Senate, which is not expected to act until Congress returns from a two-week Easter recess. Senate Democrats were initially skeptical of what they perceived as anti-abortion language in the package, but some of those concerns have since been allayed by the strong show of support for the bill among House Democrats, aides said.
Pelosi’s office also ensured the bill made clear that there would be no new restrictions on reproductive rights, maintaining only the routine language that prohibits the use of taxpayer funds on abortions.
Given the large vote in the House and backing from the White House, Senate aides said they expect no significant hurdles when they take up the bill.
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