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‘Doc Fix’ Deal Passes Without Roll Call Vote (Updated) (Video)

(Bill Clark/CQ Roll Call)
(Bill Clark/CQ Roll Call)

Updated March 27, 12:49 a.m. |  The House passed controversial “doc fix” legislation with a voice vote Thursday, after House GOP leaders spent hours scrambling to round up votes for the deal backed by Speaker John A. Boehner and Senate Majority Leader Harry Reid.

The power move bypassed a recorded roll call vote, with the votes remaining in doubt, incensing some members of the House. Asked if she went along with the voice vote plan, House Minority Leader Nancy Pelosi, D-Calif., simply said “yes.”  

Without a roll call vote, it’s impossible to know exactly who would have voted for or against the measure, or if it would have had the two-thirds needed to pass on the suspension calendar.  

The House had recessed unexpectedly Thursday morning as GOP leaders sought to round up the votes needed to pass the measure ensuring Medicare payments to doctors aren’t cut.  

“It’s looking very good,” House Majority Leader Eric Cantor said earlier. “We’re working on it.”  

Immediately after GOP aides told CQ Roll Call the bill would be pulled Thursday morning for a lack of votes, the House Republican Doctors Caucus, which had been opposed to the measure, huddled in a room off of the House floor and were soon joined by GOP leaders. Staff was kicked out of the room.
House Minority Whip Steny H. Hoyer, D-Md., told CQ Roll Call he would oppose the bill but would not whip against it, while Pelosi earlier told reporters she would vote for the bill if it came to a vote and said Reid told her he wants it to pass.  

Many Democrats would be voting “no,” she said, including two committee ranking members: Henry A. Waxman of Energy and Commerce, and Sander M. Levin of Ways and Means.  

“This is the wrong way to go,” she said. “However, you know as well as I, if this does not pass … seniors may be turned away from their physicians, and you know what Republicans will say: It was because of the Affordable Care Act. They won’t even say it that way, but that’s their point. And I just don’t want to give them another — the bill in itself, I don’t like it, but it serves a purpose.”  

Pelosi also said on Thursday morning that she wasn’t sure how the vote would go down, but suspected that Republicans didn’t have the votes.  

“I don’t know why they didn’t just bring it up under the rule, had the discussion, take the vote, but to bring it up under suspension where you have 290 votes or the equivalent of two-thirds of those present and voting, is a mystery to me, unless they thought they couldn’t get 218 votes on their side,” she said.  

The Doctors Caucus and Senate Finance Chairman Ron Wyden, D-Ore., had been pushing back against the deal Boehner announced Wednesday.  

The Ohio Republican told reporters Wednesday morning that he and Reid had struck a deal on a yearlong policy that would avoid drastic cuts to Medicare payments to physicians.  

Yet soon after, the Nevada Democrat said the deal was merely a work in progress. Wyden piled on, saying he does not support a short-term fix. And on Wednesday afternoon, key House Republicans concerned with health policy said they will most likely not support Boehner’s legislation.  

Members of the Doctors Caucus, a group of physicians in the GOP, said the policy would allow Health and Human Services Secretary Kathleen Sebelius to revalue Medicare physician payments arbitrarily to pay for the policy, which they see as a broad expansion of executive power that could hit medical specialists’s pocketbooks.  

Rep. Phil Roe, R-Tenn., a member of the caucus, crafted a letter he may send to Boehner on the matter. He noted that the group is also unhappy that the legislation was unveiled late Tuesday, giving the conference little time to absorb the specifics.  

Rep. John Fleming, R-La., another member of the caucus, said Wednesday night he did not think the bill had enough votes to pass.  

“They haven’t whipped us on it, so I’m not sure what their thinking is. I don’t think it’s right for passage,” he said. “Our caucus tends to go by what doctors recommend. So I’m not so sure our caucus, the non-physicians, are going to back something that the doctors are not going to. There’s a lot in flux until tomorrow.”  

In the Senate, Wyden noted he is pushing a 10-year fix to the Medicare formula and would rather not take up the yearlong policy, calling it a “flawed proposal” that is “bad for seniors, bad for doctors and bad for all concerned.”  

The Oregon Democrat said Boehner is on an island and announced the deal prematurely.  

“What the speaker has said, at this point, speaks for the speaker. I’ve had conversations with Sen. Reid and they’ve been ongoing and he’s very much aware of what we’re doing,” he said.  

But a senior Democratic aide later said Reid would back the short-term bill if it gets out of the House.  

“Hatch talked to Reid this evening on the phone and informed him there would be no Republican votes for the Wyden plan,” the aide said Wednesday. “So it looks like the short-term Boehner patch plan is the only one that can pass right now — and we’ll support if it comes over.”  

Wyden’s colleague on the Finance Committee, Sen. Jay Rockefeller, D-W.Va., earlier inferred that Wyden may in fact be the one scuttling a deal between Boehner and Reid.  

“Ordinarily a Finance chairman doesn’t come in and screw up a speaker and a majority leader, right?” he said.  

Either way, Fleming said he and many members of the Doctors Caucus want to push the long-term fix as well.  

“We agree with Wyden. If you’re going to do something, let’s do the 10-year thing. If we patch this thing for another year, all we’re doing is letting the cord wood stack up. We’re not solving problems,” he said. “This is one way to get something huge off the table, at least for 10 years.”  

Wyden said he was talking to Democrats and Republicans, yet his proposal may find no traction in the Senate. He said it pays for the 10-year, roughly $140 billion price from war funds, gleaned from winding down the wars in Iraq and Afghanistan. Critics of the budgeting technique say it is a gimmick because the money would never have been spent anyway.  

House Republicans have long said they will not take up any legislation that uses those war funds as an offset. Wyden acknowledged that the offset is “not exactly realistic budgeting,” but said the doc fix is “budget fakery” too.  

Pelosi expressed support for Wyden’s efforts Thursday.  

“I wish Sen. Wyden well, of course, because he’s on the right course, he’s doing the good thing, and it makes all the sense in the world. It’s the right way to go. It costs less, does more, ends the discussion,” she said. “And so it’s hard to understand why the Republicans think that this is our only option.”  

Meanwhile, members and doctors groups are concerned that a short-term fix would kill the momentum for a long-term fix. Boehner tried to scuttle that talk, telling reporters that the yearlong deal “does not preclude any work from being done on the long-term fix in terms of how we pay doctors.”  

Nevertheless, several provider groups spoke out Wednesday against the short-term patch, saying another fix could hurt a bipartisan policy agreement to replace the Medicare physician payment system.  

“Now is the time for Congress to resolve the remaining differences over how to address the budget impact of the bipartisan and bicameral SGR repeal and Medicare payment reform policies that both chambers and parties say that they support,” said American College of Physicians President Molly Cooke in a letter to House and Senate leadership. “There will never be a better time.”  

The American Academy of Family Physicians also expressed disappointment and concern with the short-term patch. President Reid Blackwelder said in a statement that, “Congress is moving away from, rather than toward the goal.”  

Emma Dumain, Steven T. Dennis, Matt Fuller and Emily Ethridge contributed to this report.    

More coverage:

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