House unveils $200B Medicare deal

A bipartisan group of senior House members unveiled legislation Tuesday to end automatic cuts to doctors under Medicare, with the bill slated to receive a vote this week.

The bill, which has been known as the “doc fix” deal, would end a decades-old payment problem for Medicare doctors, known as the sustainable growth rate (SGR). The current rate expires in one week, which puts pressure on House leaders to meet their goal of a Thursday vote.

The package is expected to cost about $200 billion, one of the bill’s sponsors, Rep. Michael Burgess (R-Texas) said late Monday. Only one-third of that cost is expected to be offset, which he acknowledged cost the bill some support in the GOP.

The costs will be shouldered roughly evenly between Medicare beneficiaries and providers.

The deal is the result of weeks of high-level negotiations led by Speaker John Boehner (R-Ohio) and Minority Leader Nancy Pelosi (D-Calif.). Both released statements praising the deal on Tuesday.

“It will put in place the first real, structural entitlement reform in nearly two decades,” Boehner wrote in a statement Tuesday.

“Of course, there are many more things we wish were included. But this is a good deal, and a big step forward on many of our priorities,” Pelosi added in a separate statement.

Much of the details unveiled Tuesday had already been known in advance, such as a provision that will require wealthy seniors on Medicare to pay more. Older Americans making more than $133,000, for example, would pay 65 percent of premium costs, up from 50 percent.

Additionally, post-acute health providers will see smaller increases in their Medicare reimbursements, increasing by no more than 1 percent in fiscal 2018.

To attract Democratic support, the bill would extend funding for the government’s Children’s Health Insurance Program (CHIP) for two years. The party has called for a four-year extension, which some Senate Democrats still argue must be included.

The bill also adds new funding for community health centers, which has also become a sticking point among some Senate Democrats. The Democrats, including Senate Minority Leader Harry Reid (D-Nev.), criticized a Republican-driven provision that they say would expand the Hyde Amendment, which prevents federal dollars from being used for abortions.

Democrats defended the deal Tuesday. Reps. Diana DeGette (D-Colo.) and Louise Slaughter (D-N.Y.), the co-chairwomen of the House Pro-Choice Caucus, put out a statement endorsing the package.

“The language included in the bipartisan compromise does not further restrict women’s access to abortion, and the provisions expire along with funding — just as the current Hyde Amendment does,” they said. “We will be supporting this bipartisan compromise, and we encourage other members of the Pro-Choice Caucus to do the same.”

To help offset the costs, the bill also includes new rules for Medicare that stress improvements in care quality and stronger data recording.

Burgess, who has spent 12 years fighting to reform the “doc fix,” said Tuesday that he is closer than at any point in his tenure to doing so. Still, he raised concerns about how the bill will be handled in the Senate, which has so far remained quiet on support for the deal.

“I think there is a reasonable expectation that this will indeed get done,” Burgess said. “I’m fully aware there are a lot of moving parts between now and when this story ends.”

— Peter Sullivan contributed.

Updated at 12:53 p.m.