Docs Fix DOA

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Senate Majority Leader Harry Reid just told reporters that he will not be moving Senator Debbie Stabenow’s 10-year, $247 billion freeze on doctors’ Medicare payments. He said he thought he had the votes – and was promised Republican 27 votes from the AMA – but has since realized he doesn’t. “I don’t bring anything to the floor unless I think I have the votes,” Reid said, answering a question about the apparent shortfall of support. “I was told by various people that we’d have 27 Republican votes, which seemed reasonable since Senator Jon Kyl was the co-sponsor of this legislation. So I was stunned when I was told by his co-sponsor, Senator Stabenow, that, no, he wouldn’t support it.”

Reid said he’s now looking at a “multiple year fix.” Jim Manley, Reid’s senior adviser, said after the press conference (which happened to be on revoking health insurers’ anti-trust exemption) that the majority leader hasn’t decided yet how many years the fix will be, though we’re still expecting a cloture vote on the motion to proceed to the issue this afternoon. Senators Conrad and Grassley have proposed a two-year fix and are looking for offsets for the $24 billion bill. The $247 billion bill had no offsets.

Kyl, the No. 2 Senate Republican, yesterday told reporters that his original bill with Stabenow – which provided for a 2.6% increase in fees Medicare pays to doctors one year and a 2.7% increase a second year – was “very different legislation” than the 10-year freeze proposed by Democrats this week. No word if a curtailed solution would still appease the AMA and AARP and whether the House might consider passing a similar stand alone bill.

The vote failed cloture 47-53. Word is Reid will not bring up his multiple year fix until after the big health care reform bill passes — whenever that may be. The AMA’s statement:

“The AMA is deeply disappointed that the Senate today blocked consideration of S. 1776, legislation to preserve access to health care for America’s seniors, baby boomers and military families. Senator Stabenow is a long-time champion for patients and physicians, and the AMA, AARP and MOAA strongly supported her bill that would have laid the foundation to permanently fix the Medicare physician payment formula and keep Medicare strong as millions of baby boomers enter the program in just two years.

“As we work to improve the health system, permanent repeal of the payment formula is essential to ensuring the security and stability of Medicare. On January first, Medicare physician payments are scheduled to be cut by 21 percent, with more cuts in years to come. Nearly 90 percent of people age 50 and older are concerned that the current Medicare physician payment formula threatens their access to care.

“While short-term fixes have temporarily averted widespread access problems, they have also grown the size of the problem – and the cost of reform. The AMA is committed to fixing the Medicare payment problem once and for all for seniors, baby boomers and the physicians who care for them.

“There is widespread agreement among Republicans and Democrats that the formula is broken and needs to be repealed. Congress created the Medicare physician payment system, and Congress needs to fix this problem once and for all to fulfill its obligation to seniors, baby boomers and military families.  Permanent repeal of the Medicare physician payment formula is essential to comprehensive health system reform.”