Dem thumbs down to Reid doctors deal

A group of Senate Democrats is threatening to derail a deal Majority Leader Harry ReidHarry ReidObama in Nevada: 'Heck no' to Trump, Joe Heck Dems double down on Nevada Latino vote Heck's rejection of Trump imperils Nevada Senate race MORE offered to doctors in exchange for their support of President Barack ObamaBarack ObamaObama in Nevada: 'Heck no' to Trump, Joe Heck Lots of (just) talk about 'draining the swamp' America’s Eastern European mess MORE’s healthcare initiative.

Sens. Kent Conrad (N.D.), Evan Bayh (Ind.), Russ Feingold (Wis.), Tom CarperTom CarperYahoo hack spurs push for legislation Election-year politics: Senate Dems shun GOP vulnerables Overnight Healthcare: McConnell unveils new Zika package | Manchin defends daughter on EpiPens | Bill includes M for opioid crisis MORE (Del.) and Claire McCaskillClaire McCaskillMcCaskill offers Trump 'Mean Girls' advice Trump's taxes bump Miss Universe from headlines Dem on NYT report: Trump 'walks away with a golden ticket' MORE (Mo.) on Tuesday voiced opposition to separate legislation that would freeze scheduled cuts in Medicare payments to doctors for the next 10 years.

Passing the “doctors’ fix” on the Senate floor this week is central to Reid’s (D-Nev.) strategy for passing a broad healthcare reform bill in coming weeks. Reid told doctors groups in a private meeting last week that he would bring the payment fix bill to the floor but that in return he expected their help in passing the healthcare package later this year.

But the five Democrats are insisting that the legislation, which costs $247 billion, be offset with spending cuts or tax increases. The legislation, which was discussed at the Democratic policy lunch on Tuesday, is not offset in its current form.

Reid had hoped to hold a procedural vote Monday night to call the bill up on the Senate floor, but the objections from within his party have slowed the process down.

Reid seemed to acknowledge Tuesday that Democrats may have to back off from their plan to solidify support from doctors by passing a 10-year fix.

“I’ve had a number of discussions with Kent Conrad, and we’re going to take care of the senior citizens and the doctors,” Reid told reporters. “As I’ve indicated, it could be a one-year fix, it could be a 10-year fix, but we’re going to take care of them.”

Doctors groups such as the American Medical Association (AMA) are considered pivotal players in the debate, and the senators’ opposition to freezing the cuts could derail reform. AMA president J. James Rohack has said doctors would not be inclined to support reform if it does not address the steep cuts to their Medicare payments put in place by a 1997 law.

House Democratic leaders also held firm in objecting to the legislation Tuesday, insisting that the Senate agree to offset the cost of the doctor payments with tax increases or spending cuts, or agree to implement pay-as-you-go budget rules for most legislation, which senators have firmly resisted in recent years.

House Majority Leader Steny Hoyer (D-Md.) said House Democrats would take a stand on the issue after repeatedly backing down from similar confrontations with the Senate in recent years over expensive measures the upper chamber had failed to pay for.

The intra-party feud comes shortly after the deficit reached a record high of $1.4 trillion for fiscal 2009.

“Look, we’re serious about statutory pay-go,” said Hoyer. “We’re serious about focusing on fiscal discipline, and this is part of it. I had a discussion with Sen. Reid last week and I expect to have another discussion with him about it this week.”

Hoyer said that he and Speaker Nancy Pelosi (D-Calif.) reiterated their concerns about passing the doctors legislation without offsets with White House Chief of Staff Rahm Emanuel last week.

Pelosi and Hoyer made their position clear in a letter sent to lawmakers who negotiated the joint congressional budget resolution earlier this year.

Sen. Debbie StabenowDebbie StabenowGreat Lakes senators seek boost for maritime system Podesta floated Bill Gates, Bloomberg as possible Clinton VPs Dems to McConnell: Pass 'clean' extension of Iran sanctions MORE (D-Mich.), the lead sponsor of the Senate measure, said Tuesday that she hoped House leaders could be persuaded to accept the legislation if Congress changed how it calculated the budget deficit. Stabenow argues that freezing scheduled cuts in doctors’ payments should not count against the deficit, since lawmakers from both parties have assumed this would happen every year.

But Hoyer has rejected that argument.

When asked if he could “buy that strategy,” Hoyer answered bluntly: “No.”

Senate Democratic leaders acknowledged they would have to rely on Republicans to pass the doctors legislation.

“We need Republican support,” said Senate Democratic Whip Dick DurbinDick DurbinGreat Lakes senators seek boost for maritime system Wikileaks: Durbin pushed unknown Warren for Obama bank regulator The Hill's 12:30 Report MORE (Ill.). “If the Republicans are in support of strengthening Medicare, saving it so that that doctors don’t leave Medicare, they need to show it with their votes.

“They haven’t told us how they want to pay for it,” Durbin said.

Senate Democratic Conference Vice Chairman Charles SchumerCharles SchumerImmigration was barely covered in the debates GOP leaders advise members to proceed with caution on Trump Senate Dems demand answers from Wells Fargo over treatment of military MORE (N.Y.) said the decision on whether to fix doctors’ payments now rests with Republicans.

“We’re committed to getting this done, but the first question is, Are there enough Republicans?” Schumer said.

Seventeen Republicans voted for legislation averting cuts to doctor payments in July of last year. Democrats scored a big victory on July 9, when the late Sen. Edward Kennedy (D-Mass.) surprised colleagues by appearing on the Senate floor after being diagnosed with terminal cancer to cast the decisive vote. After Kennedy tipped the balance, several GOP senators rushed to support the bill.

Of the 17 Republicans who voted for a one-year freeze in scheduled cuts, 11 are still in the upper chamber: Sens. Lamar AlexanderLamar AlexanderObama meets a crossroads for his healthcare law Music streamer Spotify joins Gillibrand’s push for paid family leave GOP senators avoid Trump questions on rigged election MORE (Tenn.), Saxby ChamblissSaxby ChamblissWyden hammers CIA chief over Senate spying Cruz is a liability Inside Paul Ryan’s brain trust MORE (Ga.), Susan CollinsSusan CollinsRepublican opposition to raising the minimum wage Is crumbling 5 takeaways from the Indiana Senate debate GOP senators avoid Trump questions on rigged election MORE (Maine), Bob CorkerBob CorkerGlobal climate pact may bump into Senate roadblock GOP senators avoid Trump questions on rigged election Trump appoints fundraiser to national security advisory council MORE (Tenn.), John CornynJohn CornynReport: Investor visa program mainly funds wealthy areas GOP senators avoid Trump questions on rigged election Conservatives backing Trump keep focus on Supreme Court MORE (Texas), Kay Bailey Hutchison (Texas), Johnny IsaksonJohnny IsaksonIs Georgia turning blue? GOP senators avoid Trump questions on rigged election Dems seek cash to expand Senate map MORE (Ga.), Lisa MurkowskiLisa MurkowskiWriting in Mike Pence won’t do any good in these states GOP senators avoid Trump questions on rigged election Trump campaign left out of Alaska voter guide MORE (Alaska), Pat RobertsPat RobertsGOP senators avoid Trump questions on rigged election More Senate Republicans pressure Treasury over debt-equity rules GOP leaders advise members to proceed with caution on Trump MORE (Kan.), Olympia Snowe (Maine) and George Voinovich (Ohio).

Several of those Republicans, however, appear unlikely to vote for a $247 billion bill without offsets only days after the Obama administration estimated the rising federal deficit.

During a floor speech Tuesday morning, Corker criticized Democrats for trying to buy the support of doctors for broader healthcare reform. Cornyn is planning to offer an amendment that would pay for part of the doctors’ payments by implementing medical malpractice reform, which Democrats oppose, according to a GOP source

Murkowski said she is unlikely to support the doctors fix for 10 years unless it is paid for.

Roberts said he did not know how he would vote on the legislation to fix doctors’ payments. He said he would wait to see what amendments are offered and how the debate plays out.

But Democrats may not need to go any further than proposing the fix, Roberts said. The mere fact of trying to pass a 10-year freeze may help Democrats earn the allegiance of some doctors groups, or at least make it easier to pillory the GOP as the “party of no.”

“It’s a very clever way for Harry to propose this because he knows you can’t deny reimbursements to doctors,” Roberts said.  

Jeffrey Young and Walter Alarkon contributed to this article.