Senate Republicans Block Debate on Bill That Would Delay Medicare Physician Payment Cut

Senate Democrats on Thursday failed to obtain the 60 votes required to invoke cloture and begin debate on a bill (S 3101) that would delay for 18 months a 10.6% reduction in Medicare physician fees scheduled to take effect on July 1 and increase payments by 1.1%, among other provisions, CQ Today reports. The Senate voted 54-39 in favor of cloture (Wayne, CQ Today, 6/12). The bill, sponsored by Senate Finance Committee Chair Max Baucus (D-Mont.), would cost about $20 billion over five years (Wilde Mathews, Wall Street Journal, 6/13). Before the cloture vote, Senate Majority Leader Harry Reid (D-Nev.) denied a request by Republicans for a similar vote on a competing bill (S 3118) introduced by Senate Finance Committee ranking member Chuck Grassley (R-Iowa) (CQ Today, 6/12). Grassley's measure would cost about $16.5 billion over five years (Wall Street Journal, 6/13).

The failed cloture vote will send the "issue back for further negotiations between Republicans and Democrats," and the "eventual upshot is likely to be a more narrowly crafted bill than the one introduced" by Baucus, the Wall Street Journal reports. However, "some aspects of the Grassley and Baucus bills are common and are likely to survive in the Senate's final version," the Journal reports. One such provision is a measure that would provide incentives for physicians to adopt electronic prescribing. According to the Journal, "[I]t isn't clear whether Congress will make the deadline" to delay the reduction in Medicare physician reimbursements or "attempt to restore the higher fee levels retroactively" (Wall Street Journal, 6/13).

Absences
The cloture vote "came up short because of Republican support for" the Grassley bill and "key absences from the Democratic caucus," The Hill reports (Young, The Hill, 6/12). According to CQ Today, in the event that five absent Democrats had voted, the "cloture motion likely would have succeeded." Reid changed his vote from "yes" to "no" to allow him to hold a subsequent vote on the bill under parliamentary rules (CQ Today, 6/12).

The absent Democrats included presumptive presidential nominee Sen. Barack Obama (Ill.), former presidential candidate Sen. Hillary Rodham Clinton (N.Y.) and Sen. Edward Kennedy (Mass.), who recently was diagnosed with brain cancer (The Hill, 6/12). However, additional votes would "have been needed to override an expected veto," which President Bush threatened on Thursday, CongressDaily reports (Edney, CongressDaily, 6/13).

Comments
Baucus said, "We all know what this vote was about, and it wasn't about what's best for American seniors," adding, "The White House doesn't want overpaid private plans in Medicare to lose a single dime" (The Hill, 6/12).

Grassley said, "Congress has 18 days left to make sure doctors serving Medicare patients don't get hit with a Draconian cut that would put them in the position of not being able to serve seniors," adding, "I hope that this failed vote will get us to the negotiating table" (Freking, AP/Chicago Tribune, 6/12).