Speaker Nancy Pelosi opened the door Thursday to House passage of a six-month extension in increased Medicare payment rates to doctors, less than a week after she effectively declared the Senate-passed measure dead on arrival in her chamber.

The “doc fix,” which would restore Medicare payment cuts that took effect Friday, was a last-minute addition to the House floor schedule, and the House began debating the measure late Thursday afternoon.

The California Democrat told reporters Thursday that she still considered the legislation, which Senate Republicans agreed to let Majority Leader Harry Reid (D-Nev.) move June 18, “totally inadequate” and “poorly written.” But after another week in which the Senate has made little progress toward passing a tax extenders package that includes a longer “doc fix” extension as well as an extension of expired middle-class tax breaks and jobless benefits, Pelosi said she was left with little choice but to consider taking up the Senate-passed measure.

“It’s clear they’re not able to do anything this week,” Pelosi said, referring to Senate efforts to pass the tax extenders package, which Democrats want passed in large part because it would restore unemployment benefits.

Passing the six-month extension, Pelosi said, could “clear the way for discussing the bigger package.”

On Friday, Pelosi blasted the Senate-passed “doc fix,” and said she saw “no reason to pass this inadequate bill until we see jobs legislation coming out of the Senate.” Pelosi spokesman Nadeam Elshami downplayed the decision to act now on the Senate bill, saying that Senate Republicans had left House Democrats little choice, given the “changes after changes after changes” being made to the broader bill in the Senate.

Pelosi also placed the blame for Senate inaction on the broader package squarely on Senate Republicans’ shoulders, saying she was “very, very disappointed” that the extenders legislation had stalled across the Capitol.

“The fact is this: The Senate Republicans have rejected every job initiative that has been sent over there in the past six months,” she said.

Pelosi said she was not inclined to try to pass more short-term unemployment extensions, unless she thought there were 60 votes in the Senate.

“I’m hard-put to pass any more initiatives here unless there’s some reasonable prospect for success on the Senate side,” Pelosi said, adding that “unemployment insurance is an emergency” and that she would continue to work to chart a path to restore those benefits.