Senate Searches for Medicare ‘Doc Fix’ Amendments

With a vocal opposition that has grown over the two-week recess, Senate leadership is looking for a path forward on legislation that would strike down Medicare’s unpopular Sustainable Growth Rate formula.

The legislation passed the House 392-37 last month with an unexpectedly bipartisan vote. Despite a ticking clock – the Centers for Medicare and Medicaid Services will start processing claims with cut payments on Wednesday – the bill could face a rockier road in the Senate.

Senate Republicans and Democrats are searching for the right mix of amendments that could, in part, offer the necessary political cover for both sides to accept the legislation’s riskier components: for Republicans, that includes the $141 billion that the legislation doesn’t cover with corresponding cuts to other programs. For Democrats, it’s a two-year extension of a children’s health insurance program when many in the caucus would have preferred four, and so-called “Hyde amendment” abortion language typically included on appropriations legislation.

Senate Finance Committee Chairman Orrin Hatch (R-Utah) could offer a package with three Republican amendments and three Democrat amendments tomorrow, according to sources who spoke anonymously because negotiations were not final. The Republican amendments could include a measure from Sen. Mike Lee (R-Utah) that would require the legislation be subject to the “PAYGO” rules, which would end up automatically cutting Medicare if the entire cost of the “doc fix” legislation isn’t covered.