Heads Up: Medicare Physician “Bailout” on Debt Limit Next Week
As an FYI, we have received word from multiple sources that the Senate may consider an unpaid-for SGR “fix” as part of the increase in the debt limit (H.J.Res. 45) being brought to the floor next week under a UC propounded in December. It remains unclear whether the Stabenow Senate bill (S. 1776) or the House bill (H.R. 3961) will be the vehicle for debate; however, any legislation providing a long-term “doc fix” is likely to raise the deficit by upwards of $200 billion – and will be voted on in the context of legislation increasing the debt limit by up to $1.8 trillion.
As a demonstration of how the SGR bill comports with demands for “fiscal responsibility” in Washington, below is a transcript from This Week on October 18, where George Stephanopoulos questioned David Axelrod as the Senate prepared to debate the Stabenow bill last fall. You will note that his lone defense of the bill was that an SGR fix was “in the budget” – even though the President’s budget also proposed to increase the deficit by $330 billion in order to pay for a long-term SGR fix. Video of the exchange can be found here (exchange begins with 7:45 remaining in the video) – by my count, Axelrod used the word “um” at least 15 times in a 90-second span while trying to square an unpaid-for SGR bill with the President’s promise of a deficit-neutral bill.
STEPHANOPOULOS: The president has drawn one other very red line in the sand, that he won’t sign any health care bill that increases the deficit. (BEGIN VIDEO CLIP)
OBAMA: I will not sign a plan that adds one dime to our deficits, either now or in the future. (APPLAUSE) I will not sign it if it adds one dime to the deficit now or in the future, period. (END VIDEO CLIP)
STEPHANOPOULOS: Yet just this week, the Senate majority leader, Harry Reid, is going to bring a bill to the floor that — Republicans call this the first installment on health care, which is going to permanently repeal savings gotten from payments — Medicare payments to doctors, $248 billion over 10 years. Must that be paid for, for the president to sign it?
AXELROD: George, first of all, understand that that — when the Republicans say this is the first installment on health care, it’s not part of the health care bill. This — this has been — there’s been…
STEPHANOPOULOS: It was in the House bill.
AXELROD: Yes, but the point is that, every year, this — this provision of the Medicare law goes into effect. Every year, draconian cuts are proposed for doctors that would have a deleterious effect on patients. And every year, the Congress acts on it and defers on that. And the fact is, it’s a charade. Everyone in the Congress knows they’re not going to let that go forward. All that we’re saying here is, let’s be honest about it. The president provided for it in his budgets, and we ought to acknowledge that this is a — this is an ongoing expense that we’ll have to meet.
STEPHANOPOULOS: But isn’t it actually — isn’t it also a charade if you’re saying, “We’re going to do this. We’re not going to pay for this $248 billion,” and that’s the only way you can end up not increasing the deficit… (CROSSTALK)
AXELROD: Well, it will be — it will be part of the budget. It will be paid for as we move — as we move forward. The fundamental health reform, George, that we’re talking about that would provide subsidies to people who can’t afford health care today and ancillary expenses are all going to be paid for.
STEPHANOPOULOS: But will — would this particular bill have to be paid for? Because the House — Speaker Nancy Pelosi has said that she’s not going to pass it through her chamber unless there are specific things… (CROSSTALK)
AXELROD: As I said, the president’s provided for it in his — in his budget, and we will account for it.