• Doc Fixed
  • April 21, 2015
  • Law Firm: McDonald Hopkins LLC - Cleveland Office
  • This week, the Senate overwhelmingly approved the permanent Medicare doc-fix bill, 92-8, and the White House has indicated that President Obama will sign the bill, which would put an end to one of Congress's most-hated rituals.

    Two of the eight votes against the measure came from senators running for president - with Senator Ted Cruz (R-TX) and Senator Marco Rubio (R-FL) opposing the bill. The third GOP presidential hopeful in the Senate, Senator Rand Paul (R-KY), voted for the legislation.

    Cruz derided the bill for not being fully paid for, citing an estimate that it could add as much as $500 billion to the federal deficit in the next 20 years. According to the official Congressional Budget Office score, the bill is expected to cost about $210 billion in the next 10 years, with $70 billion directly offset through cuts to providers and beneficiaries.

    Cruz, Rubio, and Paul all backed an amendment from Sen. Mike Lee (R-UT) that would have required the bill's full costs to be offset. The amendment, pushed by deficit hawks unhappy about the bill's costs, failed.

    All three senators voted for an amendment to pay for the bill by repealing Obamacare's individual mandate, though it failed to reach the 60-vote threshold to pass.

    The doc fix, negotiated by House Speaker John Boehner and Minority Leader Nancy Pelosi, permanently repeals the Medicare "sustainable growth rate" formula, which routinely threatened 20-percent pay cuts to doctors unless Congress fixed it once or twice a year. It also sets up a transition to performance-based Medicare payments to doctors.

    The measure reforms Medicare in several other ways, enacting a deductible for Medigap plans and expanding means-testing for Medicare's outpatient and drug programs. Cost became an issue during the congressional debate. Supporters assert it will pay for itself in the long term, but opponents argued that it would add even more to the deficit across a longer timeline.