Medicare Pay Fix For Doctors Hitches Ride On Jobs Bill

Snowstorm or not, the Senate is plowing ahead with legislation that is supposed to create new jobs with tax breaks for employers. One provision is clearly intended to help preserve a few very important jobs — those of senators up for reelection this year.

Physicians are the immediate beneficiaries of a provision in the jobs bill that would postpone a 21 percent cut in the amount Medicare pays them. Unless Congress acts by March 1, that haircut by the huge federal program for the elderly and disabled is automatic.

But it’s not doctors lawmakers really fear. It’s seniors who will be furious if their doctors stop taking Medicare patients because payments are too stingy. And why are seniors so important? Because they vote. And in non-presidential election years like this one, they vote in disproportionate numbers.

But fixing the so-called ‘doc fee’ problem has proved problematic. One reason is that it’s expensive. Very expensive. Hundreds of billions of dollars expensive.

The problem stems from a glitch in the pay formula Congress created back in the 1997 Balanced Budget Act. For four years, doctors got larger increases than they probably should have. But since 2001, the formula started calling for cuts. That year, Congress let those cuts take effect. But since then, its been putting them off, usually a year at a time. And the postponed cuts have piled up.

During the height of the debate over health overhaul in December, Congress delayed the cuts by a mere two months. Now Republicans and Democrats can’t agree how much longer to postpone them.

Republicans, after defeating a bill to eliminate the problem once and for all last November, now say they want to delay the cuts for a full year. Democrats are advocating a shorter delay.

Why the difference? Republicans don’t want to give Democrats a “must-pass” bill to which they might potentially be able to attach a broader health overhaul bill before the end of the current Congress.