Democrats Struggle To Line Up Benefits Extension Bill Votes, Scaling Back ‘Doc Fix’ Is On The Table

Lawmakers continue to work Wednesday on a jobs and benefits bill that would extend subsidies to help laid-off workers keep their health insurance and would avert payment cuts to Medicare doctors.  

CQ: "House and Senate Democrats continued to struggle Wednesday to salvage a nearly $200 billion package of tax cuts and social spending. With the Memorial Day recess fast approaching, Democrats are beginning to consider scaled-back versions of the compromise bill (HR 4213) unveiled last week by the chairmen of the tax-writing committees. Senate Majority Leader Harry Reid, D-Nev., has suggested to House leaders that he could get 60 votes for the measure if they scale back a Medicare doctor-payment provision to two years from 3.5 years and shorten the unemployment and COBRA health insurance extensions by a month from the Dec. 31 expiration dates in the bill, according to House Democratic aides." Senate Finance Chairman Max Baucus, D-Mont., was optimistic that Senate Democrats would find the needed votes, but he chose not to discuss details of possible bill changes.  

Meanwhile, the House went into recess late Wednesday morning as Democratic leaders "worked to finalize changes to the bill and nail down votes from Democrats wary about expanding the federal budget deficit." Rep. Chris Van Hollen, D-Md., assistant to the Speaker, acknowledged that it "would be 'difficult' to have a vote on the extenders legislation Wednesday, as initially planned" (Schatz and Rubin, 5/26).

Roll Call: Senate Minority Leader Mitch McConnell Wednesday morning "made a pre-emptive strike on the tax extenders bill, suggesting the chamber approve the GOP's alternative before adjourning for the Memorial Day break." His comments came as Democratic leaders were working to "garner the necessary votes to pass before Friday, when Congress is set to adjourn for a weeklong recess. The House is slated to move first on the issue, with the Senate expected to take up a measure after considering the $60 billion war supplemental measure." Fiscal conservatives in both the House and the Senate "want the bill paid for, while liberals maintain that extending the tax breaks and funding for unemployment insurance benefits qualifies as emergency spending" (Brady, 5/26).

The Hill: McConnell also "signaled that Republicans would oppose a new tax relief and unemployment aid package that will come to the floor this week, calling the bill 'blatantly reckless.' McConnell said he would support the package only if its costs were fully offset by spending cuts.  The Congressional Budget Office estimates the measure would add $134 billion to the federal deficit over ten years. Reid said Tuesday he would be willing to hold the Senate in session over the holiday weekend to pass a $58.8 billion emergency supplemental and the extenders package. ... He repeated his threat on Wednesday" (Bolton, 5/26).

Reuters: "With many lawmakers balking at the package's $134 billion cost, Democratic leaders considered scaling back a provision that would prevent drastic pay cuts for doctors who see patients in the Medicare health-insurance program, according to congressional staffers and lobbyists.  Some medical groups said they could live with the shorter time frame. The bill's $174 billion in new spending is offset by $40 billion in new taxes, according to the nonpartisan Congressional Budget Office (Sullivan and Dixon, 5/26).

Modern HealthCare: "Healthcare lobbyists tracking the ever-shifting 'doc fix' said they expect an 18-month pay freeze-an about-face from at least two other proposals that would have given doctors a slight update for a year and a half while temporarily refiguring the formula Medicare uses to determine payments. Much of the cost comes from a proposed 3.5-year refiguring of physician payments, which the Congressional Budget Office estimates would add $64.6 billion to the deficit. Other big-ticket items include a $47 billion measure to extend COBRA premium subsidies for the unemployed through the end of the year and $24 billion to keep a higher level of federal Medicaid payments in place" (DoBias, 5/26). 

Roll Call, in an earlier story: "Democratic infighting could put the blame for inaction squarely on the majority's back. Unless Democratic leaders can get their act together quickly, unemployment benefits will expire while Congress is on its weeklong Memorial Day recess. On Tuesday, House and Senate Democratic leaders were still struggling to find the votes to pass a nearly $200 billion tax extenders bill that happens to include the latest extension of unemployment benefits. That extension would last until the end of the year." Many say the bill is too expensive and Democratic defections are "piling up" (Pierce and Dennis, 5/25).

Related KHN coverage: How The Tax Bill Would Affect Medicare, Medicaid And COBRA Subsidies (Villegas, 5/26).