Medicare physician pay patch delayed during House focus on health reform

Washington -- The Senate's March 10 approval of a tax extenders bill that would put off a 21% cut in physician Medicare payments until Oct. 1 sent the legislation back to the House for approval. But House Democratic leaders initially put the extenders bill on the sidelines until they could complete work on comprehensive health system reform.

The House passed an earlier version of the extenders bill that includes tax breaks but not the Medicare pay patch or extensions of unemployment and health assistance programs. The House could pass the Senate bill as is to send it to President Obama's desk before the next cut takes effect April 1. But the Senate voted to pay for part of the cost of the measure using budgetary offsets that Obama requested be used instead to lower the cost of national health system reform, prompting House leaders to hold off consideration until the larger reform bill was settled.

With Congress scheduled to recess March 26 for its Easter break, and with the possibility that the House would make changes to the extenders bill that needed to go back to the Senate for approval, time was tight to approve the latest Medicare payment patch. Congressional leaders did not rule out approving another month-long solution if the Oct. 1 extension could not clear in time.

Congress has run out of time to prevent cuts before. The 21% cut initially took effect March 1, prompting the American Medical Association to warn of a "Medicare meltdown." But Senate Democrats late the next day were able to overcome a procedural roadblock, reversing the reduction and delaying its return for one month.

Some policy experts said the House will be able to act before the 21% cut strikes again on April 1.

"The House is pretty easy to pass something, so they should be able to do it before the Easter recess," said Brian Darling, director of Senate relations for the conservative Heritage Foundation. "We've seen the pressure on members of Congress to get something passed, and there are clearly the votes needed in the House to get this done."