The House is inching closer to a major deal on Medicare payments that could help cement a legacy for Speaker John BoehnerJohn Andrew BoehnerLobbying world A new kind of hero? Last week's emotional TV may be a sign GOP up in arms over Cheney, Kinzinger MORE.
BoehnerJohn Andrew BoehnerLobbying world A new kind of hero? Last week's emotional TV may be a sign GOP up in arms over Cheney, Kinzinger MORE has spent two months quietly working with Minority Leader Nancy Pelosi to finally solve a Medicare payment problem that has eluded congressional leaders for more than 20 years.
The House leaders are expected to unveil their $200 billion Medicare deal early next week. Facing little opposition so far, the proposal is bringing Boehner closer than ever to tackling his long-time goal of entitlement reform.
"This could be one of the two or three accomplishments of the 114th Congress," said a GOP leadership aide. "It's a really big deal."
The bill would repeal a Medicare formula known as the sustainable growth rate (SGR), which calculates payments to doctors. In a crucial first step toward what would be a once-in-a-generation dea, bipartisan bills were introduced in both the House and Senate on Thursday.
House leadership offices will now spend the week whipping votes, aiming for final passage before this year’s SGR formula expires on March 31.
"I'm encouraged by what we've seen and hope we can end this problem once and for all," Boehner said Thursday as he spoke publicly about his plans for the first time.
The stakes are high for Boehner, who tried and failed — with much fanfare — to secure a deal on the Medicare formula last year. Those efforts ended in a 17th temporary “patch” for the SGR.
This year, both House leaders say they are ready to compromise — giving Boehner a second chance at uniting his caucus around a deal.
"I think it's important for us to get as big a vote on our side as we can because it's an expression of support and confidence for the Speaker," Rep. Tom Cole (R-Okla.) told The Hill on Thursday.
It’s unclear how many conservatives will oppose the bill, with many keeping quiet until they see the final details. Both Rep. Bill FloresWilliam (Bill) Hose FloresThe Hill's Morning Report - Presented by the UAE Embassy in Washington, DC - Calls mount to start transition as Biden readies Cabinet picks Hillicon Valley: House votes to condemn QAnon | Americans worried about foreign election interference | DHS confirms request to tap protester phones House approves measure condemning QAnon, but 17 Republicans vote against it MORE (R-Texas), the chairman of the conservative Republican Study Committee, and Rep. Jim Jordan (R-Ohio), chairman of the House Freedom Caucus, say they don’t yet have a position.
Cole, a member of the GOP whipping team, said he believes there is "certainly enough" support for passage.
"The speaker has clearly made a decision that its time to end this thing," he said. "It's actually the first thing since the 'cromnibus' that gives me a little bit of hope that we can do some things cooperatively around here."
The Boehner-Pelosi deal would end an 20-year long headache for the healthcare industry.
“I'm crossing my fingers. I’m knocking on wood,” said a senior staffer who is close to the talks. “For so many years, we never had an answer. It was incredibly frustrating to all parties involved."
Congress began using the SGR in the late 1990s as a temporary tool to constrain Medicare spending. But after more than a dozen attempts to avert the same funding cliff, healthcare policy staffers and lobbyists said they had reached the final straw.
“Having a battle that happens every year for nearly 20 years is unprecedented. We’re at a moment of exhaustion here,” one healthcare lobbyist said.
After last year’s failed talks, members of the House GOP Doctors Caucus tried to seize on last year’s election successes to give the SGR repeal another shot.
But after the 18-member group met with Boehner early in 2015, few emerged with optimism. Rep. John FlemingJohn Calvin FlemingLobbying world Trump wants Congress to delay Census deadlines amid pandemic Meadows sets up coronavirus hotline for members of Congress MORE, (R-La.), co-chair of the Doctors Caucus, said he was floored when he learned Boehner was advancing the SGR repeal.
“I came out kind of pessimistic about it,” Fleming told The Hill in a recent interview. “We left pretty much thinking this was going to be the same old situation where we were.”
House leaders restarted talks on the SGR about two months ago, at a time when Boehner and Pelosi were publicly sparring over funding for the Homeland Security Department.
Boehner told reporters Thursday that an opportunity “presented itself to work in a bipartisan way” to find ways to partially pay for the bill.
“The door opened and I decided to walk in it,” he said.
The deal would mark House Republicans’ first concrete move to tackle entitlement spending. It was only made possible because of the willingness by House Democrats to strike a deal, aides said.
“This is the first time Democrats have been willing to say yes to a compromise on entitlement reform without calling for major tax hikes.” the leadership aide said. “That is a very important step forward in terms of ultimately balancing our budget and ultimately saving Medicare.”
Several Democratic senators, however, say they want more sweeteners in the deal. They are pressing, in particular, for a four-year extension of the children’s insurance insurance program (CHIP), rather than two years. A draft of the deal released late Friday shows that the House deal will likely include the two-year extension.
Pelosi told reporters Thursday that she expects to have bipartisan agreement, adding that “it will be a good agreement.”
Rep. Eliot Engel (D-N.Y.), said this week that he wants to see four more years of CHIP, though he added, “I wouldn't say two years would make it a negative for me.”
He believes the deal, even if it is imperfect, could be good for the House as a whole.
“I'm hoping that this might be the start of Pelosi and Boehner getting together and trying to see where there's common ground so you can't have the Tea Party hold everything captive,” Engel said. “And you cannot have a situation where everything goes to the eleventh hour and the public thinks less and less of us.”
- Peter Sullivan contributed