GOP wins could help doctors get their fix

Capitol Hill and K Street are starting to wonder if a Republican victory in the House or Senate could be good news for doctors in 2011.

One of the biggest issues in the lame duck session will be the Medicare “doc fix,” a political hot potato that needs to be tackled to avoid a 30 percent cut in Medicare physician payment rates on Jan. 1.

Physicians are asking for a 13-month fix to the problem, and sources say a Republican victory could create momentum for that to happen in November.

Sources on Capitol Hill and K Street say there are a couple reasons for doctors to be optimistic.

Republicans elected in a tidal wave of voter anger at federal spending would have an obvious incentive to put the costly “fix” on the outgoing Democrats' tab rather than giving billions of dollars to doctors as one of their first legislative acts, said two Republican House staffers.

It’s unclear how much the 13-month fix would cost, but the Congressional Budget Office estimate this year of a permanent fix predicted it would be $330 billion over 10 years.

“It's an issue we all want solved,” one staffer said. “It's not a particularly easy problem, so to that extent, yeah, solve it as fast as possible.”

Democrats could also have some reason to move on the doctor fix.

They would want to avoid handing victorious Republicans a must-pass health bill that they could then use as a vehicle to tear apart the health reform law, sources said.

“Unfinished business from this year that costs them money is stuff (Republicans) are not going to want to deal with,” the former staffer said. “Having said that, if you look at the flip side of the equation, the administration and Democrats who are worried about Republicans nit-picking at the healthcare bill - how many healthcare vehicles do they really want to have out there?”

The former staffer pointed out that Republicans could use such a vehicle as a means to try to eliminate or weaken provisions they dislike, such as the payment advisory board and research on drugs and procedures that provide the best value for money. Republicans would also likely try to pay for a doc fix with medical malpractice reforms, as they have done in the past.

“That's a question the White House and the Democrats on the Hill are going to have to contemplate in the lame duck,” the former staffer said.

Adding to the pressure: Dozens of physician groups from around the country wrote to House Speaker Nancy Pelosi (D-Calif.) and Minority Leader John BoehnerJohn Andrew BoehnerRift widens between business groups and House GOP Juan Williams: Pelosi shows her power Debt ceiling games endanger US fiscal credibility — again MORE (R-Ohio) last week requesting them to “take action during the first week” of the lame-duck session. The infuriated doctors want lawmakers to patch the system through the end of 2011 so Congress will have time to develop a long-term solution to the perennial problem, which culminated in 2010 with several short-term cuts that forced some doctors to seek loans or lay off staff.

“Hundreds of thousands of physicians will be considering whether they can continue accepting Medicare rates at the same time that massive payment cuts are scheduled to take effect,” the letter states. “We can anticipate that many physicians will be examining whether it makes sense to continue their current relationship with Medicare given the severe disruptions.