Hurdles surface, but optimism remains for permanent 'doc fix'

A permanent "doc fix" plan—negotiated by House Speaker John Boehnerand Minority Leader Nancy Pelosi—will need to gain traction in the coming days if it's going to have a realistic shot at enactment. 

That's because both the House and Senate need time to consider a permanent fix before Congress adjourns for spring break at the end of the month. 

Congress has until March 31 to take action on the issue. Otherwise doctors would face a 21.2% decrease in payments for treating Medicare patients.

While talks continue in the House and some objections have surfaced, the contours of the deal that emerged on Friday continue to tenuously hold, according to lobbyists and staffers tracking the issue. The $215 billion package would include permanent repeal of Medicare's sustainable growth-rate formula, a two-year extension of the Children's Health Insurance Program and a two-year extension of a package of healthcare-related tax and spending provisions.

“Cautiously optimistic is the way that I would describe my feeling about the situation," said Rep. Renee Ellmers (R-N.C.), who sits on the Energy & Commerce Committee. "I am confident that it can be done."