Is Capitol Hill Ready To Rest Its Near-Annual 'Doc Fix' Exercise? : It's All Politics Doctors who treat Medicare patients will face a huge cut, 21 percent, if Congress doesn't act by the end of the month. House leaders now think they fix a problem that has plagued Congress since 1997.

Is Capitol Hill Ready To Rest Its Near-Annual 'Doc Fix' Exercise?

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Lawmakers in the House hope they are done making temporary fixes to a permanent problem.


Year after year, a deadline approaches. It's a deadline to cut back on payments to doctors who take Medicare patients. Year after year, doctors resist.

MONTAGNE: And year after year, Congress approves a temporary fix - finding money to keep up payments. This has happened 17 times. Today, the House votes on a fix that would last. NPR's Juana Summers reports.

JUANA SUMMERS, BYLINE: The Medicare doctor payment problem has bedeviled Congress since 1997. But now an unlikely partnership between House Speaker John Boehner and Democratic leader Nancy Pelosi might mean the end of it. If their plan becomes law, this bill would mean no more renewals of the so-called doc fix, what had become a near annual exercise on Capitol Hill. It would ditch the current formula. Instead, Medicare would increase payments to doctors by one-half of 1 percent each year through 2019. After that, a system would kick in where doctors would receive bonuses and penalties depending on performance scores from the government. Tennessee Congressman Phil Roe heads up the House Republican Doctors Caucus, which supports the plan.

REPRESENTATIVE PHIL ROE: We as physicians want to be - look, we want to be paid on basically how well our patient does. And that creates some challenges admittedly 'cause you've got to have buy-in from the patients. But we know these systems work, and they save money.

SUMMERS: The bill also extends the Children's Health Insurance Program, which will expire in a few months, and the bill has the backing of the White House. During an event marking the fifth anniversary of the Affordable Care Act, President Obama says that he supports the plan.


PRESIDENT BARACK OBAMA: As we speak, Congress is working to fix the Medicare physician payment system. I've got my pen ready to sign a good bipartisan bill.

SUMMERS: Though the bill has the White House's backing and bipartisan support in the House, it hit a snag in the Senate. Though it would solve a long-standing problem with the way doctors who treat Medicare patients are paid, some Democrats worry about language that would restrict abortions at community health centers. Pelosi has said the restrictions included in the bill are not a change in current policy. The bill also has the support of the chairs of the House Pro-Choice Caucus. Some Senate Democrats said yesterday that the Medicare bill's abortion language was nowhere close to the abortion curbs in the human trafficking bill the Democrats are blocking. California Democratic Senator Dianne Feinstein said she planned to support the Medicare bill.

SENATOR DIANNE FEINSTEIN: I will vote for it, yes, because my objection in the trafficking bill is that this is private money, not a government fund. So it would establish a new precedent, and that's what I don't want to do.

SUMMERS: The abortion provisions aside, there's also a question of cost. According to a Congressional Budget Office estimate, the bill would cost more than $200 billion over the next decade. The bill would add more than $140 billion to the federal budget deficit, and that's despite some savings that would come from higher premiums from some Medicare beneficiaries and cuts to providers like hospitals and nursing homes. Juana Summers, NPR News, the Capitol.

MONTAGNE: And this is MORNING EDITION from NPR News. I'm Renee Montagne.

INSKEEP: And I'm Steve Inskeep.

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