Medicare Overhaul Bill Divides GOP Presidential Candidates

WASHINGTON — Rand Paul, an ophthalmologist, voted for sweeping Medicare legislation that would permanently override cuts in payments to physicians.

Meanwhile, Ted Cruz and Marco Rubio voted against the “doc fix” because it’s projected to add $141 billion to the deficit.

The vote Tuesday night marks an interesting division between the freshman senators from Kentucky, Texas and Florida, all of whom are officially competing for the coveted Republican presidential nomination.

“While I appreciate the work done by my colleagues in the House,” said Cruz, “I cannot support the Boehner-Pelosi bill, which institutionalizes and expands Obamacare policies that harm patients and their doctors while adding roughly half a trillion dollars to our long-term debt within two decades.”

Cruz and Rubio stood with the GOP fiscal hardliners, including the conservative group Heritage Action, in objecting to the fact that the bill wasn’t fully paid for.

“While he’s supportive of parts of the bill, he was very concerned about the substantial unfunded cost and ultimately couldn’t vote for it,” a Rubio aide said.

Paul, meanwhile, stood with congressional leaders and the physician groups who have been clamoring for a permanent “doc fix” for more than a decade. The legislation replaces steep annual cuts in Medicare payments to physicians and instead gives doctors a 0.5 percent pay bump for each of the next five years.

“Sen. Rand Paul voted to permanently repeal government mandated annual decreases in medical fees,” a Paul spokesperson said. “These government mandates have been repealed every year for 17 years, indicating that this policy should never have been enacted. Ending this formula ensures that Medicare patients will continue to get quality care.”

In the end Paul had plenty of political cover because the bill passed overwhelmingly — 92-8 in the Senate and 392-37 in the House. Notably, numerous other conservative doctors in Congress set aside their deficit concerns to vote for the legislation, including Sen. John Barrasso (WY), Rep. Tom Price (GA), Rep. John Fleming (LA) and Michael Burgess (TX).

Sen. Lindsey Graham (R-SC), a fourth presidential hopeful who has not jumped in yet, also voted for the legislation.

House Speaker John Boehner (R-OH) hailed passage of the bill, which includes billions of dollars in Medicare benefit cuts for upper-income seniors. “This reform bill is a big deal,” he said. “For the first time in nearly two decades – and without raising taxes — Congress has come together in a bipartisan way to pass meaningful entitlement reform.”

The legislation next goes to President Barack Obama, who’s expected to sign it.

This article has been updated to include additional statements from the senators.

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