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A make-or-break week awaits Republican leaders in Congress

GOP leaders have two chances this week to prove their effectiveness in Congress. Will they?

This week offers a make-or-break moment for Republican leaders on Capitol Hill.

After stumbling several times since taking control of Congress earlier this year, House Speaker John A. Boehner (R-Ohio) and Senate Majority Leader Mitch McConnell (R-Ky.) have an opportunity to demonstrate on two important fronts that Republicans can effectively govern.

But it remains unclear if they will be able to deliver.

Boehner acknowledged Tuesday the momentous days ahead, as Republicans will try to pass their annual budget for fiscal 2016 and approve a sweeping bipartisan accord to overhaul the way doctors are paid under Medicare.

"Well, this is a big week for the House's focus on the people's priorities," Boehner said.

Unable to unite feuding Republicans around a single budget blueprint, GOP leaders in the House are resorting to a rarely used procedure -- dubbed "Queen of the Hill" -- that allows lawmakers to vote on whichever plan they prefer. The one with the most votes advances.

It was seen as the only way to resolve a standoff between the party's defense hawks and deficit sharks that has threatened to derail the entire process.

Defense backers want to boost Pentagon spending and counter the austerity cuts demanded by deficit watchers in a 2011 deal. GOP deficit watchers, meanwhile, are trying to hold the line against new government spending.

Debate began Tuesday, but with lawmakers scheduled to break early for a fundraising dinner with former Vice President Dick Cheney, votes were not expected until Wednesday.

The first plan, approved by the House Budget Committee under Chairman Tom Price (R-Ga.), imposes steep cuts on social services while boosting military money. But to avoid increasing the deficit, it makes the military increases contingent on spending cuts in other areas, which would be determined in the future.

The second plan, also offered by Price, includes an even larger Pentagon increase and abandons the contingency requirement, thereby raising the deficit. Defense hawks favor this approach because they fear that under the first plan, the Pentagon will never see the extra money because it will be too difficult to agree on the mandatory cuts.

Boehner made it clear he thinks the defense hawks will win the day by approving the second plan. He called the exercise "the most democratic -- small D -- way" to resolve the issue.

"The budget alternative that gets the most votes is the one that goes on to final passage, and I think that's a great way to do it," Boehner said, noting that the House routinely votes on other budget proposals by various caucus groups, including progressives and conservatives.

The Senate, meanwhile, has begun debates and votes on its plan.

Republicans in the Senate initially declined to explicitly increase defense funds, but then revised their plan to be more in line with the House GOP. The Senate version similarly boosts military money, but promises to offset the increases with unspecified defense reductions in the future.

McConnell acknowledged that budgets often require compromise, and "this one is certainly that."

Both chambers hope to approve their budgets by the end of the week. If the remaining differences between the House and Senate can be reconciled, passage would mark a milestone for Congress, which has been unable agree on budgets in recent years.

That would go a long way in supporting the GOP's promise to run Congress more efficiently and effectively than during the time Democrats controlled the Senate and Republicans held the House.

Less certain is the outlook for the ambitious proposal to fix a long-standing dispute over payments to doctors under Medicare.

Boehner and House Minority Leader Nancy Pelosi (D-San Francisco) have spent weeks negotiating the intricate deal that would prevent doctors from facing a substantial pay cut set to take effect by March 31.

The so-called doc-fix deal is just the kind of bipartisan compromise both sides say they want, but rarely find. Passage would be a unique achievement for a Congress that in recent years has usually only provided stopgap fixes that prolong tough decisions.

And that is what is making the outcome so uncertain.

The accord would replace the doctors' reimbursement rate with a new formula, ending years of uncertainty and reining in costs. 

In exchange for their support, Democrats negotiated a two-year extension of a popular children's healthcare program, which is expiring at the end of the fiscal year.

Part of the costs of the compromise would be offset by asking the wealthiest 2% of seniors to pay more for their Medicare insurance premiums.

But some Democrats still oppose asking seniors to pay more for Medicare. The premium hikes would hit Medicare beneficiaries with adjusted gross incomes above $133,500 a year, or $267,000 for married couples.

And some Republicans are hesitant to agree to a deal that is not fully paid for with spending reductions elsewhere.

Senate Democrats have been particularly cool to the deal, believing Pelosi could have struck a better one.

Senate Minority Leader Harry Reid (D-Nev.) indicated Tuesday he was in no rush to approve the package.

Some Democrats are pushing for a four-year extension of the children's healthcare program. Senate Democrats are also fuming over language inserted into the bill that would restrict any of the taxpayer payments to the doctors to be used for abortion services, except in limited cases of rape, incest or a threat to the life of the mother.

Those abortion restrictions have been approved by Congress as part of the appropriations process every year for more than 30 years under the Hyde Amendment. But Democrats say Republicans, seeking to quietly expand abortion restrictions, have been increasingly attaching the same language to other measures, including an anti-human-trafficking bill that has stalled over the provision.

Democrats suggested Tuesday they may be able to postpone a decision, because billing procedures for Medicare doctors means cuts wouldn't fully begin until mid-April.

With Congress set to take a two-week recess Friday for the Easter and Passover holidays, Republicans could emerge having accomplished two big tasks.

That would notch a win for the new leadership that has struggled to keep its majority in line for the first few months of the year.

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