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.

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“I’m ready to vote for it today,” Sen. John BarrassoJohn Anthony BarrassoLife after Yucca Mountain: The time has come to reset US nuclear waste policy Trump announces restart to Taliban peace talks in surprise Afghanistan visit Centrist Democrats seize on state election wins to rail against Warren's agenda 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 RyanHouse Ethics Committee informs Duncan Hunter he can no longer vote after guilty plea Duncan Hunter pleads guilty after changing plea Trump campaign steps up attacks on Biden MORE (R-Wis.) said Thursday. “They’re really cutting it close if they don’t pass it.”

Speaker John BoehnerJohn Andrew BoehnerFormer Speaker Boehner's official portrait unveiled Key Republicans say Biden can break Washington gridlock From learning on his feet to policy director 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 BoehnerFormer Speaker Boehner's official portrait unveiled Key Republicans say Biden can break Washington gridlock From learning on his feet to policy director MORE said he believes the bill will ultimately pass both chambers.

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“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 McConnellDemocrats seek leverage for trial Democrats spend big to put Senate in play House Democrats to vote on flavored e-cigarettes ban next year MORE (R-Ky.) could seek unanimous consent to approve the Medicare deal before the chamber leaves town for a two-week recess.


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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 CornynLive coverage: DOJ inspector general testifies on Capitol Hill Hillicon Valley: Apple, Facebook defend encryption during Senate grilling | Tech legal shield makes it into trade deal | Impeachment controversy over phone records heats up | TikTok chief cancels Capitol Hill meetings Apple, Facebook defend encryption during Senate grilling 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 BurgessHillicon Valley: House passes anti-robocall bill | Senators inch forward on privacy legislation | Trump escalates fight over tech tax | Illinois families sue TikTok | Senators get classified briefing on ransomware House passes anti-robocall bill Overnight Health Care: GOP senator says drug price action unlikely this year | House panel weighs ban on flavored e-cigs | New York sues Juul 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.