http://thehill.com/policy/healthcare/237068-house-passes-medicare-deal-in-overwhelming-392-37-voteBy Peter Sullivan and Cristina Marcos - 03/26/15 12:12 PM EDT
The House on Thursday overwhelmingly voted to repeal automatic cuts to doctors under Medicare, endorsing a rare bipartisan deal that Speaker John Boehner (R-Ohio) negotiated with Democrats.
The bill, which passed by a vote of 392-37, puts Congress on the precipice of ending a nearly two-decade-long fight over a formula known as the Sustainable Growth Rate (SGR).
Since 2003, lawmakers have put off cuts under the Medicare formula 17 times, perennially punting the solution through short-term “fixes” that, over time, ran up the cost of abolishing the formula to nearly $200 billion dollars.
Facing a new deadline for the cuts at the end of March, Boehner said he decided it was time to make a deal.
"We’ve had a patch of this problem 17 times," Boehner said in a rare speech on the House floor. "And I decided about a year ago that I had had enough."
Boehner and House Minority Leader Nancy Pelosi (D-Calif.) have been in negotiations over the measure since January and worked quietly to bring their members behind it.
Only 33 Republicans and 4 Democrats voted against the bill.
Pelosi praised the deal, saying it had been a “privilege” to work with Boehner “in a bipartisan way on this legislation.
"I hope it will be a model of things to come," she said.
Boehner likewise touted the bipartisanship and argued passage of the bill was a step toward broader entitlement reform.
"This is what we can accomplish when we focus on finding common ground," he said.
But while the mood in the House was celebratory, the fate of the legislation in the Senate remains unclear.
Senate Democrats have given the bill a frosty reception, raising concerns about abortion language and the length of an extension for a children’s insurance program.
But some Democratic senators appeared to be warming up to the deal on Wednesday, and President Obama gave it a strong endorsement, saying he has his “pen ready” to sign it.
Boehner told reporters ahead of the vote that he expects the Senate to take up the bill “sooner rather than later.” But he declined to say when that vote could take place.
“All I know is that the House is going to have a very large vote today,” he said.
The Senate is in the middle of a “vote-a-rama” on budget amendments that is expected to stretch into the early hours of the morning. Once the budget is passed, Senate Majority Leader Mitch McConnell (R-Ky.) could seek unanimous consent to approve the Medicare deal before the chamber leaves town for a two-week recess.
But if any senator objects to unanimous consent on the bill, it could force Congress to again pass a short-term “doc fix” to buy time for a Senate debate in April.
The deal crafted by Boehner and Pelosi would costs $214 billion over 10 years, with $73 billion of that cost offset with spending cuts or new revenue, according to the Congressional Budget Office (CBO). The bill includes reforms to transition Medicare’s payment system from incentivizing quantity to quality in care and is likely to produce small savings for the government over time, according to the CBO.
Boehner has said the bill would cost less than if Congress continued on its current course of approving short-term patches.
