Senate tees up votes on $200B Medicare deal

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The Senate is poised to vote Tuesday on a handful of amendments to a roughly $200 billion Medicare deal, according to three people familiar with the negotiations.

Senate leaders are expected to enforce limited debate on the amendments, creating the high bar of 60 votes for passage, according to a lobbyist familiar with the talks. 

“We don’t want to amend this bill to death; we want three simple amendments,” Minority Leader Harry Reid (D-Nev.) said Monday from the Senate floor.

{mosads}Reid did not specify what proposals the amendments would contain. But two people familiar with the talks, including a Senate Democratic aide, said Democrats want a four-year extension of the Children’s Health Insurance Program, the removal of abortion-related language known as the Hyde Amendment and a repeal of the Medicare therapy cap.

The children’s insurance program is extended for two years under the bill, which House Minority Leader Nancy Pelosi (D-Calif.) has described as one of the critical compromises in the deal. But Senate Democrats have repeatedly argued that two years is not enough.

Repeal of the Medicare therapy cap, which limits outpatient coverage, has been a top priority for groups such as AARP.

“This is a noncontroversial amendment that will help beneficiaries across the country. This is something that will improve the bill,” Ariel Gonzalez, director of federal health and family advocacy for AARP, said in an interview.

Reid said he would agree to a “very, very short time agreement” on the amendments, so lawmakers could act quickly on the legislation, which would end Medicare’s sustainable growth rate, and with it, a policy problem that has vexed Congress for two decades.

Senate Republicans are also planning at least one amendment. Sen. Mike Lee (R-Utah) announced Sunday that he wanted Congress to pay for the $141 billion “under its normal ‘Pay As You Go’ budget rules,” which he said would prevent the full cost from being added to the deficit. 

“With the Wednesday deadline bearing down on us, it’s too late to give taxpayers their rightful place at the table. My amendment will at least make sure we don’t stick them with the bill,” Lee, who is up for reelection in 2016, wrote in an op-ed for the Deseret News.

Lawmakers have for years passed a series of “doc fixes” to prevent cuts under the SGR for doctors. The House bill, negotiated by Speaker John Boehner (R-Ohio) and Pelosi, would repeal the cuts at a cost of roughly $150 billion.

The House overwhelmingly passed the legislation in March, with only 37 members voting against the bill.

The Senate has until Wednesday to pass a bill before Medicare doctors are faced with a 21 percent cut in their payment reimbursement rates, the Centers for Medicare and Medicaid Services said last week.

Some of the country’s largest groups are urging the Senate to pass the bill as written, warning any changes could jeopardize the entire deal.

“The bipartisan support for H.R. 2 in the House set a clear directive for the Senate, and we encourage them to pass this legislation swiftly and without revision,” the American Health Care Association wrote in a statement Monday.

— This story was last updated at 7:06 p.m.

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