After spending hundreds of thousands of dollars on ad campaigns to pressure Republican Senators and mobilizing millions of senior citizens to call Congressional offices, there is no guarantee that either the American Medical Association or the AARP will get much bang for their buck when the Senate has its second vote on the so-called Medicare doctors’ fix this week.

Indeed, GOP Senators who voted on June 26 to block consideration of the House-passed measure have been engaged in damage control for over a week with those two powerful constituencies, but none, as of press time Thursday, had offered to reverse their position to become the one vote Senate Democrats need to overcome a filibuster of the measure.

Senate Majority Leader Harry Reid (D-Nev.) will likely bring the measure up again Tuesday or Wednesday, his office said.

However, Senate Minority Leader Mitch McConnell (R-Ky.) last week sent what appears to be a strong message to his rank and file that they should continue insisting that the Senate pass a 31-day, short-term doctors’ fix rather than capitulating to demands from Democrats, physicians and senior citizens to pass the House bill.

Without passage of a new bill or an extension, doctors who serve Medicare patients face a steep 10.6-percent cut in their reimbursement rates by mid-July, a scenario the AMA has said would force many physicians to stop treating Medicare patients.

A Thursday letter to Reid, McConnell, Senate Minority Whip Jon Kyl (R-Ariz.) and Senate Finance ranking member Chuck Grassley (R-Iowa) argued that Senate passage of the House measure would be useless given President Bush’s threat to veto the measure.

“Republicans continue to believe that immediate action on a short-term extension is necessary,” the trio wrote.

“The millions of beneficiaries who depend on Medicare and the providers who treat them are not political pawns in a partisan game and Congress should not treat them that way,” the letter said.

But continuing the filibuster, as McConnell appears to be advising, could prove even more politically perilous for many Senate Republicans, considering many of them have already responded vigorously to the AMA’s lobbying blitz during the July Fourth recess.

“Physicians are very energized, and we’ve been getting calls from uncomfortable Senators,” AMA President Nancy Nielsen said.

She added, “The real proof in the pudding will not be how many calls we get or how uncomfortable Senators are, but what the votes are.”

The AMA last week began running TV and radio ads against Republican Senators in Pennsylvania, New Hampshire, Texas, Mississippi, Tennessee and Wyoming who opposed the bill.

Meanwhile, the AARP was planning on running print ads in Washington (including Roll Call) and has already alerted more than 1 million “e-activists” to call or e-mail their Senators regarding the revote, according to AARP’s president of government affairs David Sloane.

Sloane said AARP would “pull out all the stops” to get the same bipartisan vote in the Senate that the House received when it passed the bill, 355-59.

Sixty votes were needed to overcome a Senate filibuster, but the chamber fell one vote short prior to the July Fourth recess.

Despite the massive grass-roots lobbying by both groups, the reaction so far from GOP Senators has fallen short of anyone promising to switch their votes.

New Hampshire Medical Society Executive Vice President Palmer P. Jones said he has had several conversations with Sen. John Sununu (R-N.H.), who is facing a stiff challenge from former Democratic Gov. Jeanne Shaheen this fall.

Still, he said he has received no assurances from Sununu that the vulnerable incumbent will switch his vote this week.

“That’s one of the frustrations on our part because we got assurances months ago that everything would be fine,” Jones said.

He added that his group would hold a joint news conference with the New Hampshire AARP on Tuesday to urge passage of the House bill, which would prevent the cuts from taking effect for another 18 months.

The New Hampshire Medical Society has asked its 5,000-strong membership to call both Sununu and Sen. Judd Gregg (R-N.H.) to pressure them to change their votes.

After the Texas Medical Association withdrew its endorsement of Sen. John Cornyn (R-Texas) following the Senate vote, Cornyn attempted to mitigate the damage by sending a letter to doctors in his state reassuring them that they will not have to take a pay cut and blaming Democrats for objecting to a short-term extension.

“As you know, President Bush has threatened to veto” the bill, Cornyn wrote in the July 1 letter. “It would have made more sense to reach a bipartisan compromise rather than go through a lengthy veto process. However, the final outcome will be the same — the physician payment cut will be prevented.”

Similarly, Sen. Arlen Specter (R-Pa.) has attempted to tamp down the uproar over his vote to block the measure from coming up, particularly since he voted a week earlier to bring the measure up for debate. Specter held a news conference after the vote to explain his position.

He also called on President Bush to bring Congress back into session to address the fix.

Specter and other Republicans have said they opposed the bill not necessarily on the merits but because Senate Democrats were trying to ram it through without debate or amendments.

But Nielsen said the process argument doesn’t hold much water with doctors facing pay cuts.

“We don’t dictate the process by which things happen, but we do depend on the outcome,” she said.

Other Republicans, such as Grassley and Cornyn, have argued the bill makes unfair changes and cuts to Medicare Advantage, a program run by private health insurers and used by many rural seniors.

The AARP’s Sloane said his organization sees that argument as a red herring and does not oppose the changes to Medicare Advantage.

Despite the threats from AMA — one of the Republicans’ most reliable constituencies — and the nonpartisan AARP, Senate GOP aides said last week that they doubted the vote total would change if Reid follows through on his plan to call a revote this week.

The fallout from opposing the House measure “doesn’t change anyone’s electoral outlook,” argued one senior Senate GOP aide. “It just creates headaches back home, and they have to deal with it.”

But Reid spokesman Rodell Mollineau said Democrats believe it’s “very possible” a few GOP Senators could switch their vote this week as a result of the outside lobbying campaign.

“Senate Republicans need to stop hiding behind the president and should do what’s right for seniors, doctors and the Medicare program,” Mollineau said.