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Fast Money & Foreign Objects
By JENNIFER STEINHAUER and ROBERT PEARMARCH 26, 2015
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The House speaker, John A. Boehner, at a news conference on Thursday in Washington. The House approved sweeping changes to Medicare on Thursday by passing a bill negotiated by Mr. Boehner and the House Democratic leader, Representative Nancy Pelosi of California. CreditGabriella Demczuk for The New York Times
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The House speaker, John A. Boehner, at a news conference on Thursday in Washington. The House approved sweeping changes to Medicare on Thursday by passing a bill negotiated by Mr. Boehner and the House Democratic leader, Representative Nancy Pelosi of California. CreditGabriella Demczuk for The New York Times
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- Medicaresystem on Thursday, in the most significant bipartisan policy legislation to pass through that chamber since the Republicans regained a majority in 2011.
The measure, which would establish a new formula for paying doctors and end a problem that has bedeviled the nation’s health care system for more than a decade, has already been blessed by President Obama, and awaits a vote in the Senate. The bill would also increase premiums for some higher income beneficiaries and extend a popular health insurance program for children.
The legislation, which passed on a 392-to-37 vote, embodies a rare andsignificant agreement negotiated by Speaker John A. Boehner and the House Democratic leader, Representative Nancy Pelosi of California, two leaders who are so often at odds with each other.
Mr. Boehner’s strategy of working out a significant legislative compromise with Ms. Pelosi is a break from his previous attempts to mollify his most conservative members in the House.
The speaker made an unusual appearance during a floor debate Thursday morning to praise the bill as benefiting Medicare patients, children and taxpayers. “Normally we’d be here to admit we are going to kick the can down the road one more time,” he said. “But today, because of what we are doing, we are going to save money 20, 30, 40 years down the road.” Then he added, ”This is what we can accomplish when we’re focused on finding common ground.”
Ms. Pelosi again demonstrated that even as the leader of a minority party that is at times restless for fresh leadership, she has the ability to simultaneously win policy fights for Democrats while persuading them to accept hard losses.
The bill puts in place “the first real structural entitlement reform in nearly two decades” Mr. Boehner said this week, and ends “one of Washington’s most infamous budget gimmicks.”
“Don’t look now but we are actually governing,” said Representative Renee Ellmers, Republican of North Carolina.
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On the House floor Thursday morning, Democrats and Republicans both praised the bills and the process, sounding strikingly similar in their comity.
“It’s not a perfect bill,” said Representative Ami Bera, Democrat of California, who is a physician. “But I came to Congress to put people first. I came to Congress to work across the aisle in a bipartisan way to put our country first.”
Representative Dan Benishek, a Republican from Michigan who is also a physician, said, “Today’s legislation may not be perfect,” but “I urge all my colleagues to support this common sense, overdue fix.”
Senate Democrats have been resistant to provisions in the bill that preserve restrictions on the use of federal money for abortion services and extend a children’s health program for only two years, but they are expected to eventually work with Senate Republicans to pass the measure.
The timing was uncertain and the final vote could be put off until after a two-week recess scheduled to start Friday.
Doctors face a 21 percent cut in Medicare fees on April 1 unless Congress takes action. Medicare officials could stretch the deadline and delay the cuts for about two weeks.
Since 2003, Congress has passed 17 short-term bills to block cuts in Medicare doctors’ fees, which are calculated under a formula that defines a “sustainable growth rate” linked to growth of the overall economy. The Boehner-Pelosi bill repeals that formula.
Under the bill, Medicare would pay doctors based on their performance, rewarding them for high-quality work rather than the volume of services. The Children’s Health Insurance Program would be extended for two years, rather than the four years sought by Democrats. More money also would be appropriated for community health centers, with a restriction for abortion services.
To help offset the costs, some higher-income Medicare beneficiaries would be required to pay more expensive premiums for coverage of doctors’ services and prescription drugs. But about two-thirds of the costs would be added to the deficit. The Congressional Budget Office estimated that the bill would add $141 billion to federal budget deficits in the coming decade, compared with existing law.
“From beginning to end, this bill is about access,” said Representative Michael C. Burgess, Republican of Texas. “Access for our seniors, access for those who use our nation’s 9,000 community health centers and more than eight million children who receive their care at some point during the year through the Children’s Health Insurance Program.”
- http://www.nytimes.com/2015/03/27/u..._id&bicmst=1409232722000&bicmet=1419773522000
