Senate Democrats Threaten To Block Major House Deal On Medicare

WASHINGTON — Senate Democrats have emerged as a potential stumbling block to a major agreement being finalized by House leaders to enact a permanent “doc fix” and make other significant long-term cuts to Medicare.

Their main gripe: The package only extends the Children’s Health Care Program, which helps insure families with kids, for two years once funding expires at the end of September, which they say isn’t long enough. Many Democrats want at least a four-year extension.

Sen. Chris Murphy (D-CT) said a fix for children’s health insurance should be done for the same length as a fix for Medicare physician payments, which are poised for a steep 21 percent cut on April 1 under the existing “Sustainable Growth Rate” formula.

“I don’t understand why we wouldn’t ask for CHIP to be extended at the same length as SGR. I want to help our doctors but I also want to make sure kids keep insurance in my state,” he said. “Two years is too short for me. I don’t want to be back here debating whether or not kids get insurance two years from now.”

Senate Minority Whip Dick Durbin (D-IL) told TPM that the two-year extension is “problematic” and said, “I think it should be four.”

Progressive Sen. Sherrod Brown (D-OH), the sponsor of a four-year CHIP extension bill which all Democrats have cosponsored, told TPM that Democrats would unite against a two-year deal.

“I think the Democrats are all gonna hang together in the Senate and say we insist on four years,” Brown said in an interview.

“How do you fix it for doctors forever and only fix it for children for two years? I mean, that’s not the way we ought to do it. We ought to have a minimum four-year clean bill on CHIP at the same time we do the doctors’ fix,” the senator said.

Sen. Brian Schatz (D-HI) said that “two years is not a genuine commitment” for CHIP and “not good enough,” calling that view the “general mood in the caucus.”

It’s not clear if the Senate Democratic opposition reflects a negotiating posture, or if the caucus would rally around a filibuster if they don’t get their wish. The final deals of the Boehner-Pelosi accord have not been released yet, but House leadership aides say they’re aiming to complete it and bring it to a vote as early as next week. Top House Democrats said they also prefer a four-year CHIP extension but would be willing to accept a two-year deal.

Murphy also expressed concerns about the long-term Medicare savings, which include requiring high-income seniors to pay more for the program and reducing spending on supplemental “Medigap” plans that some elderly beneficiaries use.

“I worry that it prevents us from using that as an offset for a future conversation on entitlement reform. I think eventually we’re going to get to a place where we’re gonna ask higher-income seniors to pay a little bit more for Medicare,” he said. “I just don’t know that this is the place where we should trade that away.”

Sen. Ben Cardin (D-MD) was more circumspect about the emerging deal, telling TPM: “There are some things I don’t like about it, but I’ll wait to see the package and see what passes the House. But there are some parts that I don’t like.”

The “doc fix” is one of Congress’s most hated rituals — physicians and health industry groups have been demanding a permanent solution for years.

Senate Republicans, meanwhile, appeared more supportive of the framework of the House deal, including Senate Majority Whip John Cornyn (R-TX) and Senate Republican Policy Committee Chair John Barrasso (R-WY). But they said they wanted to read the bill before endorsing it.

“Anything we can do to get away from these six-month patches and Groundhog Day approach to the doc fix, I think, would be viewed as constructive,” Cornyn said. “And if there’s meaningful entitlement reform as part of that, that has some attraction.”