By Anne L. Kim, CQ Roll Call
March 14, 2014 -- The House recently passed legislation that would change the way Medicare pays doctors, with an offset that is expected to be scrapped by the Democratic-controlled Senate.
The chamber passed the bill (HR 4015) by a 238-181 vote. A dozen Democrats voted in favor.
The measure would repeal the sustainable growth rate formula in current law, and replace it with systems to adjust payments based on performance factors or on a provider's participation in alternative payment models.
While lawmakers have agreed on the policy, which constitutes the underlying bill, they are divided over how to pay for it.
Under the rule (H Res 515) that provided for floor consideration, the House automatically adopted an amendment by Ways and Means Chairman Dave Camp, R-Mich., that would offset the bill's $138 billion cost with a five-year delay of the 2010 health care law's (PL 111-148, PL 111-152) individual mandate penalty.
Republicans have been arguing that the Obama administration has delayed portions of the health care law for others and that exemptions should be extended to all individuals.
The proposal may not be the final version of the bill, but it's time for the Senate to pass their own version and appoint conferees, said Rep. Phil Gingrey, R-Ga.
"Let's go to conference, let's work with the Senate to get a pay for that can work," said Energy and Commerce Chairman Fred Upton, R-Mich.
Democrats counter that Republicans, by tacking the proposal to delay the individual mandate penalty to the bill, are thwarting a bipartisan, bicameral agreement on the sustainable growth rate formula.
"Everybody knows that this provision is a non-starter," said Rep. Diana DeGette, D-Colo.
By attaching the individual mandate penalty delay onto the bill, Republicans have singlehandedly "stomped" on months of negotiations on the sustainable growth rate formula, said Frank Pallone Jr., D-N.J.
All but one of the dozen Democrats who supported the bill last week also backed legislation (HR 4118) the House passed last week that would delay the individual mandate penalties for one year. Brad Schneider, D-Ill., did not vote on that measure. A total of 27 Democrats voted in favor of the one-year delay.
The White House threatened to veto the "doc fix" bill over the offset.
The Senate is expected to take up the issue when it returns from a weeklong recess.
Lawmakers have until the end of the month to act before the current patch (PL 113-67) expires and a 24 percent cut in Medicare physician payment rates takes place under the SGR.