Huge House vote pressures Senate

Huge House vote pressures Senate
© Greg Nash

Pressure is building for Senate leadership to take up the House’s newly passed Medicare “doc fix” bill on Friday in order to meet next week’s crucial deadline.

Attention now turns to the Senate after the House resoundingly passed legislation to end a long-running dispute over a formula for paying doctors known as the Sustainable Growth Rate (SGR).

The Senate now has about 24 hours to pass the bill to beat next week’s deadline to avert a double-digit cut to doctor payments. GOP leaders of both chambers – as well as President Obama – are now putting pressure on Senate Democrats to declare their support for the bill.

“I’m ready to vote for it today,” Sen. John BarrassoJohn Anthony BarrassoTo stave off a recession, let's pass a transportation infrastructure bill Overnight Defense: GOP wary of action on Iran | Pence says US 'locked and loaded' to defend allies | Iran's leader rules out talks with US GOP senator: Iran is behind attack on Saudi Arabia MORE (R-Wyo.), a top Senate Republican, told reporters shortly after the House bill passed 392-37. He noted that some Democrats are “opposed to the idea of even voting for it.”

Congress will not return until April 13, which will be two weeks after the doctors’ current payment rate expires. To stave off the cuts, some lawmakers have suggested that Congress could pass another temporary bill to give the Senate more time.

But considering another short-term fix would significantly slow momentum for the legislation, and House leadership have firmly said they will not consider it.

“No, we will not. This is it,” Ways and Means Chairman Paul RyanPaul Davis RyanAmash: Trump incorrect in claiming Congress didn't subpoena Obama officials Democrats hit Scalia over LGBTQ rights Three-way clash set to dominate Democratic debate MORE (R-Wis.) said Thursday. “They’re really cutting it close if they don’t pass it.”

Speaker John BoehnerJohn Andrew BoehnerIs Congress retrievable? Boehner reveals portrait done by George W. Bush Meadows to be replaced by Biggs as Freedom Caucus leader MORE (R-Ohio), who has led the deal, said Thursday that he expects the Senate to take up the bill “sooner rather than later” but declined to say when the vote could take place. When asked why few in the Senate have publicly embraced the House’s hugely bipartisan deal, BoehnerJohn Andrew BoehnerIs Congress retrievable? Boehner reveals portrait done by George W. Bush Meadows to be replaced by Biggs as Freedom Caucus leader MORE said he believes the bill will ultimately pass both chambers.

“I have no idea, but I expect, if the Senate does it take it up, there will be a large vote over there as well.” Boehner said.

Even before it officially passed, lawmakers were widely praising the Boehner-Pelosi deal. It also earned both House leaders a congratulatory phone call from President Obama, who thanked the lawmaker for agreeing even though "they didn’t get everything they wanted."

"They passed a bill. Now, hopefully the Senate will pass the bill, I’ll get to sign it and the American people will be better off for it," Obama said after his phone call.

The Senate’s chances of taking up the bill remain unclear as it continues its marathon of budget amendment votes that are slated to stretch into the early hours of the morning.

Once the budget is passed, Senate Majority Leader Mitch McConnellAddison (Mitch) Mitchell McConnellPatient advocates launch drug pricing ad campaign Overnight Defense — Presented by Boeing — House passes resolution rebuking Trump over Syria | Sparks fly at White House meeting on Syria | Dems say Trump called Pelosi a 'third-rate politician' | Trump, Graham trade jabs War of words at the White House MORE (R-Ky.) could seek unanimous consent to approve the Medicare deal before the chamber leaves town for a two-week recess.


If any senator objects to unanimous consent on the bill, it could force Congress to again pass a short-term “doc fix” to buy time for a Senate debate in April, which Senate Majority Whip John CornynJohn CornynSuccession at DHS up in the air as Trump set to nominate new head Trying to kick tobacco again This week: Congress returns to chaotic Washington MORE (R-Texas) has confirmed as a possible move.

But several lawmakers are now raising the prospects that Congress could bypass the deadline and allow the federal government to simply hold onto any checks that would be subject to a cut.

Sen. Richard Blumenthal (D-Conn.) said Thursday that he would vote against the legislation, adding that he knows of “a number of Democrats who have serious discretions.”

But Blumenthal added that the Centers for Medicaid and Medicare (CMS) could temporarily halt doctors payments for about two weeks without causing them harm – a last-ditch option that has been used during previous sessions when Congress failed to pass the bill.  

Ryan, as well as the lead sponsor of the House bill, Rep. Michael BurgessMichael Clifton BurgessTrump officials propose easing privacy rules to improve addiction treatment House approves bill raising minimum wage to per hour The 27 Republicans who voted with Democrats to block Trump from taking military action against Iran MORE (R-Texas), have also floated that backup plan as the deadline draws nearer.

“We’ve seen CMS hold checks for two weeks. We know that can happen,” Burgess told reporters, adding, “If it doesn’t pass this week, the world wouldn’t come to an end.”

But Burgess warned that it would still cause chaos because it would delay payments to doctor’s offices that may be already “running pretty close to the margin.”

Tom Scully, the former head of CMS under President George W. Bush, recalled that he was forced to hold payments in 2001 when Congress failed to pass new legislation on the doctor cuts. He said that the federal government can delay payments for about two weeks without disrupting providers’ cash flow – though there is nothing on the books that dictates when the payments must go out.

“You could hold it off for 3 months if you wanted to,” Scully said, adding that the providers will only go along with the delays if it’s nearly certain that Congress will repay them later.

“But after two weeks, it gets pretty awkward,” he said.

This story was updated at 5:48 p.m.