Without any ceremony, Senate Majority Leader Harry Reid (D-Nev.) took to the floor this afternoon and filed a motion to hold a cloture vote Monday on a 10-year, $245 billion proposal to update payments to physicians participating in Medicare.
The bill, introduced just two days ago by Sen. Debbie Stabenow (D-Mich.), would eliminate the flawed Medicare physician payment formula— called the sustainable growth rate, or SGR — and replace it with an updated process designed to better reflect the actual cost of treating those patients. You ask: Why not just stick the proposal into the larger health reform bill being weaved together this very moment by Senate leaders? Because that comprehensive bill comes with a stipulation that everything in it be paid for with spending cuts or increased revenues. The doc-fix fill, if passed separately, comes with no such stipulation because, unlike the House, the upper chamber never adopted paygo rules. (The Senate Finance Committee bill contains an $11 billion provision providing a physician pay update, but only for 2010.)
Passage of the Stabenow bill won’t be easy. Already Republicans are vowingto push amendments to offset the cost, while some moderate Democrats want to seethe legislation paid for as well. Also a potential hurdle, House Speaker Nancy Pelosi (D-Calif.) told reporters todaythat she has every intention of sticking to a promise, made earlier in the year, that any SGR fix must follow paygo rules to get her support. Monday’s cloture vote is scheduled for 5:30 p.m. on Monday, Reid said, with one hour of debate beforehand.