Repeal vote could help GOP with physicians’ lobby

After this story was published, the AMA provided a statement to The Hill denying any souring of relations with Democrats.

“The AMA has strong relationships with members of Congress on both sides of the aisle and we work to secure the best public policies for patients and physicians. One problem we have long fought to eliminate is the physician payment formula that has plagued Medicare and TRICARE with scheduled cuts for over a decade. This is a long-term problem that needs a bipartisan congressional solution,” said Dr. Jeremy Lazarus, AMA’s president-elect.

House Republicans, meanwhile, are moving forward with legislation supported by the AMA that would repeal the Independent Payment Advisory Board (IPAB), a panel established by the healthcare law to cut Medicare costs.

A number of Democrats support abolishing IPAB, but GOP leaders have tied the vote to caps on medical liability, which Democrats overwhelmingly oppose.  

While 40 to 45 Democrats were expected to vote for ending IPAB — the repeal bill has 20 Democratic co-sponsors — that number has fallen to a mere handful now that it’s been attached to medical liability reform.

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"I don't think there'll be a lot of [Democratic] votes" for the repeal bill when it comes up on the House floor, House Minority Whip Steny Hoyer (D-Md.) said Tuesday.

A high-ranking GOP aide said linking the votes was a deliberate move to deny “free votes to some Democrats who are looking to distance themselves from their healthcare vote.”

"It's not typical of any majority to give free votes to the other side,” the aide said.

But K Street sources said the maneuver was also aimed at winning the support of the AMA, which strongly supports liability caps for doctors.  

A well-connected Republican lobbyist said the decision to link the vote was spearheaded by House Majority Leader Eric Cantor (R-Va.) in an effort to “get people back in the fold who should have always been in the fold.”

"They really want that AMA golden seal of approval" for any Medicare reforms going forward, the lobbyist said, adding that Cantor “really wants to open up those [fundraising] coffers” at the AMA. 

Republican leaders strongly denied linking the bills to win the support of the AMA.

The AMA’s political action committee has donated only $97,700 to House candidates so far in the 2012 election cycle, according to the Center for Responsive Politics. The PAC donated nearly $1 million in the 2010 cycle, with the giving split evenly between Republicans and Democrats.

An AMA official said the group is spending less money on campaigning this year because there’s less healthcare legislation moving through Congress. But the official also said the group’s PAC is expected to meet in a couple of weeks to discuss future plans.

The GOP aide stressed that House leadership did not reach out to the physicians’ group before announcing its decision to link IPAB repeal and liability reform. The AMA seemed pleased by the move, however.

In a recent alert to members, the AMA called the repeal bill a "huge step forward for the medical community."

"As the vote approaches," the alert says, "it is critical to build momentum behind this important legislation that will end the threat of the IPAB to physicians and their practices through a fiscally responsible approach that reins in medical liability costs."

Other medical lobbies think adding the medical malpractice issue lessens pressure on the Senate to take up IPAB repeal, even if they're not saying so publicly.

"There is a bit of disappointment — frustration might be a good word — that leadership decided to pair the two together because of the controversy," said a physician source, adding that medical malpractice is an "unnecessarily complicating factor."

Mike Lillis contributed.

This story was updated on March 21 with a statement from the American Medical Association.