Doctors renounce GOP's permanent 'doc fix'

Doctors are taking the unprecedented step of reversing their support for a permanent "doc fix" legislative package after Republicans said they would pay for the reform by undoing a central provision of ObamaCare.

The American Medical Association (AMA), which has pushed for a decade for an overhaul to Medicare's flawed physician payment formula, appeared to renounce the legislative package over its offset in a letter to Speaker John Boehner (R-Ohio). The bill will see a House vote Friday.

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"I am writing to profess our profound disappointment that a strong bipartisan, bicameral effort to repeal the Medicare sustainable growth rate [SGR] has become a victim of partisan approaches to resolve budgetary issues," AMA CEO James L. Madara wrote on Thursday.

"Congress is closer than ever to enacting legislation that would repeal the dysfunctional Medicare physician payment system because it has worked in a bipartisan, bicameral manner for over a year. This policy will only become law if Congress collaborates in a bipartisan manner."

While the letter did not explicitly call out the GOP or its bill, Madara was criticizing a controversial move by House Republicans to pay for SGR repeal by delaying ObamaCare's individual mandate for five years. The reform would cost $138 billion over 10 years, according to budget analysts.

The move to offset the reform by undermining ObamaCare was seen as an unprecedented injection of politics into debates over the SGR, which has been characterized by quiet bipartisanship since the formula became problematic roughly 10 years ago.

The GOP pay-for ensures partisan division over a bill that otherwise had unanimous support from lawmakers in both chambers. The AMA endorsed the measure last month, urging momentum before the current patch expires on March 31, and clarified that it still supports the underlying reforms in Thursday's letter.

Madara's letter was circulated Thursday by House Minority Leader Nancy Pelosi's (D-Calif.) office, which called the GOP package "toxic" and urged Republicans to "get serious" because "time is running out."

"Doctors and health insurances oppose this legislation. Seniors' organizations and advocates oppose this legislation. The Senate isn't going to pass it, and the president won't sign it," stated an email from Pelosi's staff.

Democrats have said they will oppose Friday's vote despite their underlying support for the reform. President Obama also said Wednesday he would veto the bill because it would raise premiums and increase the number of people without health insurance.

Republicans argue that people should not be required to carry health plans under ObamaCare given the many exemptions and delays for businesses.

—This post was updated Friday at 10 a.m. to underscore the AMA's continued support for a permanent "doc fix."