Committee for a Responsible Federal Budget

Update on Senate “Doc Fix” Legislation

Oct 22, 2009 | Health Care

The Medicare physician payment bill (S 1776) sponsored by Senator Stabenow was defeated yesterday by a Senate vote of 47-53, as twelve Democrats along with Independent Joe Lieberman voted along with Republicans in favor of failing to invoke cloture on the bill. The bill would have spent $247 billion to patch ten years of cuts to physician payment rates, which have been patched annually since 2003.

In handing this somewhat significant defeat to Majority Leader Reid, Democrats and Republicans made clear their concern with adding to already unsustainable levels of debt. This vote signified the first time Democrats defected on a cloture motion this year. Many have been put off by the notion that the ten-year patch, which was not offset, was an attempt by Democratic leaders to bring down overall costs of health care reform by removing a significantly costly portion of it from the bill. Senate Budget Committee Chairman Kent Conrad was a leading voice of opposition, saying, “I’m not going to advance things that aren’t paid for by cloture vote or any other vote.” He has voiced his support for the creation of a commission to develop a permanent and fiscally responsible solution to the physician payment formula, along with other recurring budgetary problems.

The Committee for a Responsible Federal Budget applauds the Senate’s rejection of this deficit-financed ten-year pay patch. Given the nation's current fiscal state, it is absolutely essential that all new spending be paid for. As we have pointed out before, fixes like these could be paid for in a number of different ways. In a release on Tuesday, CRFB made the point that there is no reason Congress should not be able to offset a fix for Medicare physician payments, saying:

“We can’t just blindly add hundreds of billions of dollars to the debt,” said Maya MacGuineas, president of Committee for a Responsible Federal Budget. “We are already hovering on the brink of a debt crisis. What are they doing — playing chicken with our creditors?””