Amendment curbs bolster momentum for Medicare doctors bill

AP News
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Posted: Apr 13, 2015 6:32 PM

WASHINGTON (AP) — Curbs on amendments and a desire to resolve an issue that has long plagued lawmakers added momentum Monday to Senate leaders' push toward final congressional approval of legislation reshaping how Medicare reimburses doctors.

Sen. Jeff Sessions, R-Ala., said he and other conservative senators want to amend the Medicare legislation to force Congress to find a way to pay for the entire bill, saying to do otherwise "is just not responsible." The nonpartisan Congressional Budget Office says the measure would drive up federal deficits by $141 billion over the coming decade.

Some Democrats also want to amend the House-passed bill, including by providing four years of extra money for the popular Children's Health Insurance Program instead of the measure's two years.

But No. 2 Senate Republican leader John Cornyn of Texas said GOP and Democratic leaders are seeking an agreement limiting the number of amendments and requiring each to win 60 votes for passage, a process that several Democrats have said is likely. Sixty votes is a high hurdle for the 100-member Senate.

"I think it's going to be a challenge," Cornyn said when asked whether any amendments would have much chance of approval. He said leaders hoped for final approval Tuesday.

The legislation is chiefly aimed at replacing a 1997 law designed to curb the growth of Medicare, the huge health care program for the elderly.

That law has threatened ever-larger slashes in physicians' Medicare reimbursements, including a 21 percent reduction that technically took effect April 1. Over the past dozen years, Congress has blocked those cuts from occurring 17 times and lawmakers have wearied of the constant lobbying by doctors and their warnings that they might stop treating Medicare patients.

The bill would change how Medicare pays doctors, including offering financial incentives to charge patients for their overall treatment, not for each procedure. It also finances health programs for children and low-income people.

The House approved the bill last month by an overwhelming 392-37 vote, which pressured the Senate to pass the legislation unchanged. The measure was a compromise between House Speaker John Boehner, R-Ohio, and Minority Leader Nancy Pelosi, D-Calif.

Several Republicans indicated little enthusiasm Monday for amending the measure, which would return the legislation to an uncertain fate in the House.

"Given the huge margin by which it passed the House, I think this is one of those rare occasions where we are better off taking the House bill and passing it," said Sen. Susan Collins, R-Maine.

"I think I'm going to be for the bill as it's written, with no amendments," said Sen. Orrin Hatch, R-Utah.