'Doc fix' still on track despite two weeks to lose steam

Two weeks have passed since the Senate left town without taking action on legislation to permanently repeal Medicare's sustainable growth-rate formula for paying doctors. That left the deal in limbo and disappointed healthcare advocates who thought that a permanent “doc fix” was imminent.

But with Congress set to return on Tuesday, no serious threats to the deal have emerged and the Senate appears poised to end the decade-plus cycle of short-term fixes.

“I don't see anything that could actually disrupt the final outcome,” said John Rother, president of the nonpartisan National Coalition on Healthcare and previously a longtime lobbyist for AARP. “I do think that people understand the importance and the desirability of putting an end to this charade.”

The House passed the $200 billion package, which also includes a two-year extension of the Children's Health Insurance Program and $7.2 billion in funding for community health centers, by an overwhelming bipartisan margin. That put pressure on the Senate to act on the deal cooked up behind closed doors by House Speaker John Boehner (R-Ohio) and Minority Leader Nancy Pelosi (D-Calif.).

But the procedural rules of the Senate could still make passage tricky if any member wants to derail the legislation. Despite the overwhelming support in the House, the repeal package remains controversial on both sides of the aisle.