Reporting from Washington —
Breaking a logjam that has bedeviled doctors who treat the elderly, the Senate voted Friday to postpone a scheduled 21% cut in physician payments under Medicare.
The bill would postpone the cuts until Nov. 30, while Congress tries to develop a longer-term plan for paying doctors. But it will not become law until the House clears it, probably early next week.
The Medicare issue has been caught up in the congressional battle over a catchall $140-billion bill that would revive lapsed benefits for the long-term unemployed, extend a hodgepodge of tax breaks for businesses and individuals, provide aid to cash-strapped states and fund other programs intended to promote job creation.
The bill, to which the Medicare fee cut reprieve had been attached, had bogged down in the Senate because of complaints about its cost. That long-stalled measure hit a wall Thursday when the Senate failed, on a 56-40 vote, to cut off a Republican-led filibuster, four votes short of the 60 needed to end debate.
Democratic leaders are looking for changes to curb the bill's costs, but aides say it is not clear when or how that will happen.
But pressure was mounting to act more quickly to block the Medicare rate cut. Lawmakers were afraid that because the rate cut began to take effect June 1, doctors would stop taking elderly patients. Democratic and Republican Senate leaders agreed to break the issue out of the stalled bill, and passed the six-month reprieve.
Doctors complained that the fee cut would take effect anyway because the House has not yet approved the bill, so claims have begun to be processed on the reduced rate schedule.
"This is no way to run a major health coverage program — already the instability caused by repeated short-term delays is taking its toll," said Cecil B. Wilson, president of the American Medical Assn.
The fee cut has its roots in a 1997 budget law that put in place a series of cost-saving measures in Medicare. Congress decided not to let them all be implemented and voted repeatedly to postpone the doctors' rate cuts.
Faced with increased pressure to curb deficit spending, the Senate compromise Friday would offset the $6.5-billion cost of delaying the doctors' rate cut with revenues raised from changes, supported by both parties, in pension law and healthcare accounting.