After a marathon session of voting on budget bill amendments, Senate leaders failed Friday to bring up a vote on a potentially historic compromise to fix Medicare’s system for paying doctors and to extend funding for a popular government health insurance program for children.
The inaction means Medicare will start processing a 21% cut in fees to physicians on Wednesday, though the reduced payments will not start hitting medical offices until the middle of next month.
Senators, meanwhile, will have to take up the stalled healthcare package after they return from their two-week recess on April 13, one day before doctors will start to see the effects of the cut.
Senate Majority Leader Mitch McConnell (R-Ky.), who could not persuade a handful of lawmakers to drop their opposition to quick action on the bill, expressed confidence early Friday that the Senate would act quickly when it returns.
President Obama has also said he would sign the bill, which drew support from dozens of influential interest groups on the left and right, despite lingering opposition to parts of the package from some parties.
The new Medicare fee system would replace a widely discredited program, known as the Sustainable Growth Rate, that subjects physicians to nearly annual threats of fee cuts, which Congress has routinely voted to override.
The new system would impose more regular 0.5% fee increases over the next four years and create modest incentives to reward physicians who hit quality and efficiency targets.
Major medical groups, who have been pushing for a deal for years, called on senators Friday not to delay any further.
“We urge the Senate to immediately address this issue upon their return and, once and for all, lay this destructive issue to rest by building the stable and sustainable Medicare program that our nation’s patients and physicians need and deserve,” said Dr. Robert M. Wah, president of the American Medical Assn.
The two parties in the House agreed not to offset most of the $200-billion cost of the legislation, a move that forced Republicans to buck budget hawks who have complained that the package would add $140 billion to future budget deficits.
Democrats, meanwhile, agreed to just a two-year reauthorization of funding for the Children’s Health Insurance Program, or CHIP, rather than the four years many advocates and governors wanted.
They also accepted new cost-sharing requirements for Medicare beneficiaries, including a restriction that stops Medigap plans from paying beneficiaries’ $147 deductible for physician services. Millions of seniors rely on such commercial plans to help pay for out-of-pocket medical expenses not covered by Medicare.
To renew funding for community health centers, Democrats also went along with longstanding restrictions on the centers’ use of federal funding for abortion services.