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By Jeffrey Young
Posted: 06/24/08 07:23 PM [ET]
The House’s surprising and overwhelming passage of a Democratic Medicare bill on Tuesday has significantly changed the dynamic of how Congress plans to address a fast-approaching cut in the program. The vote was a major win for House Democratic leaders and a stunning loss for Republicans in the lower chamber who had predicted victory. And it is the latest example of House Democrats trumping their Senate counterparts on a major issue.
After being frustrated with the Senate for most of the 110th Congress, House Democrats have been the driving force over the last couple of weeks. The Medicare vote follows deals struck by the House on the Foreign Intelligence Surveillance Act and the war supplemental.
House Democratic leaders gambled by putting the bill, which seeks to avoid Medicare physician fee cuts, on the suspension calendar. Bills under suspension rules require a two-thirds majority, and Minority Whip Roy Blunt (R-Mo.) had said last week that Democrats would fall short.
Republican leaders and the White House have balked at the bill because it calls for spending reductions to Medicare Advantage health plans.
However, the House passed the measure with a veto-proof majority, 355-59, with 129 Republicans joining all Democrats who voted to approve the bill. Several members of the GOP leadership cast votes for the legislation, as did many politically vulnerable Republicans.
Democratic Caucus Chairman Rahm Emanuel (Ill.), who led the charge in the Democratic takeover of the House, put out a release on Monday suggesting Republicans would pay a political price if they voted no: “Will Republicans vote to protect seniors, the disabled and the doctors who treat them, and improve Medicare? Or will they once again side with the biggest corporate plans? Seniors and disabled Americans across the country will be watching.”
House Speaker Nancy Pelosi (D-Calif.), following the vote, said, “[Tuesday’s] bipartisan and veto-proof vote sends a strong signal that improving care for seniors and ensuring fair payment for providers will not be held hostage to the White House’s insistence on bloated, unnecessary subsidies for private health insurance plans that participate in Medicare.”
Senate Majority Leader Harry Reid (D-Nev.) moved swiftly to begin the process of bringing the House-passed bill directly to the floor. “As evidenced by the overwhelming House vote, this bill enjoys significant bipartisan support,” a spokesman wrote in an e-mail, adding that Reid hopes the Senate will “pass it as quickly as possible.”
Though the legislative calendar in both chambers is crowded with high-profile items, the looming physician fee cut has created a sense of urgency. The House bill — like a measure crafted by Senate Finance Committee Chairman Max Baucus (D-Mont.) — would forestall a 10.6 percent cut in Medicare payments to physicians, which will automatically take effect July 1 unless legislation is enacted. In place of the cut, the bill would hold payments at their current level for the rest of this year and establish a 1.1 percent pay hike in 2009.
For most of the year, House Democrats mostly sat on the sidelines while Baucus sought a deal with his Republican counterpart, Sen. Chuck Grassley (Iowa), on a bipartisan measure that could get the 60 votes needed to obtain cloture in the Senate, or even the 67 needed to override a presidential veto.
Though the physician-payment provisions enjoy broad support, lawmakers have been unable to agree on how to offset the cost of the physician fee fix and other new spending, which was estimated at up to $20 billion over five years.
Whether Baucus and Grassley’s efforts would have succeeded may be moot if the House-passed bill can meet either or both of those thresholds.
Even as word began to circulate around Capitol Hill and on K Street that Baucus and Grassley had come to a tentative agreement, news of the House vote quickly spread to the Senate.
House Minority Leader John Boehner (R-Ohio), House Republican Conference Vice Chairwoman Kay Granger (R-Texas) and Blunt voted against the bill.
House GOP leaders who voted yes included Republican Conference Chairman Adam Putnam (Fla.) and House Republican Policy Committee Chairman Thaddeus McCotter (Mich.) and Vice Chairman Michael Burgess (Texas), as well as several committee ranking members.
After the vote, House Majority Leader Steny Hoyer (D-Md.) said, “This overwhelming vote should send a strong signal to the Senate, where virtually identical legislation introduced by Sen. Baucus has been stalled by Senate Republicans.”
As time ran out on the House vote and it became clear it had reached the necessary number for passage, at least 18 Republicans switched their “no” votes to “yes.”
“At the end of the day, the Democrats really chose to jam us on this. … This was all designed to make this as difficult for us as possible,” a House Republican aide said.
Shortly before the vote began, Energy and Commerce Committee ranking member Joe Barton (R-Texas) predicted that Democrats had little chance of winning over many Republicans. “We were not part of the process,” he said, adding, “There’s a 95 to 100 percent chance we’re going to be ‘nos’ regardless of the substance of the bill.”
In the end, more than enough Republicans proved him wrong, including Rep. Nathan Deal (Ga.), the ranking member of the Health Subcommittee of Barton’s panel.
The House bill is based on a Baucus-penned measure that failed to achieve cloture in the Senate on June 12. Although the White House threatened to veto the original Baucus bill and the House-passed bill, the overwhelming vote in the lower chamber could make Republican senators rethink their previous permission.
Nine Republicans voted for cloture on the first Baucus bill, including most of the members Democrats are targeting this cycle. If every Democrat who was absent that day vote for the House-passed bill except the ailing Sen. Edward Kennedy (D-Mass.), cloture would come up one vote short.
Such a scenario could put considerable pressure on Sen. John Sununu (R-N.H.), who was not present for the June 12 vote and faces a difficult reelection campaign against former Gov. Jeanne Shaheen (D).
Republican presidential candidate Sen. John McCain (Ariz.) also missed the prior vote but is not expected to be in Washington this week.
The bill also incorporated bipartisan legislation to delay the implementation of a Medicare competitive bidding program for durable medical equipment, also slated to take effect July 1. That measure, sponsored by Reps. Pete Stark (D-Calif.) and Dave Camp (R-Mich.), had strong support from lawmakers in both parties, including Boehner.
Camp, however, voted against the Medicare bill, as did Wally Herger (R-Calif.), a rival for the ranking member slot on the Ways and Means Committee that will be open when retiring Rep. Jim McCrery’s (R-La.) term ends.
