Cowardly lawmakers use legislative skullduggery to pass Doc fix

A legislative Kabuki dance broke out in the House chamber yesterday when leaders of both parties pulled a fast one on their rank and file in order to pass a difficult legislative fix to how the government pays doctors treating Medicare patients.

Roll Call:

The House on Thursday passed a bill that likely did not have the votes to pass.

It was clear that a bill to avert a pay hike for doctors was short on support, so Republican leaders struck a closed-door agreement with Democrats to pass the bill by voice vote while members were not yet in the chamber, according to members and aides from both parties.

The bipartisan power move to hold a voice vote allowed members to avoid a tough roll call, which would have forced them either to vote for a bill they do not support or allow doctors who treat Medicare patients to take a pay cut, incensing powerful outside interests.

The tactic flies in the face of Speaker John A. Boehner’s pledge to be a transparent and rule-abiding Congress, members and aides said.

“I’ve seen a lot of dumb things, but I’ve never seen anything quite as comical as this,” Rep. John D. Dingell, D-Mich., the longest serving member in the history of Congress, told CQ Roll Call.

Rep. Lynn Westmoreland, R-Ga., said House leaders essentially passed the bill while members’ backs were turned. “No one objected. No one was there to object,” he said.

The bill was supposed to come to the floor early Thursday morning, but the vote was postponed into the afternoon as Majority Leader Eric Cantor, R-Va., Majority Whip Kevin McCarthy, R-Calif., and other leaders huddled with members of their party in a room beside the House floor to try to round up support.

Republican aides said at the time that the bill would most likely be pulled from consideration because it did not have the votes. Yet emerging from the room, Cantor told reporters, “We’re still working on it.”

Cantor left the room briefly to meet with Minority Whip Steny Hoyer, D-Md. That’s when the two leaders, with the backing of their respective leadership and committee chairmen, struck an agreement to call for a voice vote on the House floor without objection, members and aides said. Earlier in the day Hoyer said he would have voted against the bill. House Minority Leader Nancy Pelosi, D-Calif., asked if she went along with the voice vote plan, simply said, “Yes.”

Just what is the "Doc Fix"? It's been around since 1997 and is passed every year to keep doctors from getting a huge pay cut when treating Medicare patients. Here's Ezra Klein from 2010 when the Medicare "savings" from cutting physicians payments to Medicare patients was part of the "savings" realized in Obamacare:

In 1997, the Republican Congress wrote and passed the Balanced Budget Act, and President Clinton signed it into law. Tucked deep in the bill was a provision setting a "sustainable growth rate" for Medicare: The provision, written by the Republican chairman of the Ways and Means Committee, mandated cuts to doctor payments if the program's spending rose above a certain level.

The provision wasn't expected to save much money or be a very big deal. But the formula was based on bad assumptions, and soon SGR was requiring massive cuts. Democratic and Republican congresses alike have been delaying the cuts ever since.

Klein says that the doc fix should be considered outside of Obamacare's costs and savings. That would be fine - except when the administration was selling Obamacare, they included the savings realized from cutting physician's pay. It amounts to a staggering $500 billion over 10 years. So every year, rather than get doctors mad at them, lawmakers pass a Doc Fix to keep their pay where it is.

But this year, the GOP tried to tie the Doc Fix to repeal of the individual mandate. Demcorats refused to walk the plank on the bill, while Republicans needed the Doc Fix to avoid being blamed for cutting the pay of doctors. In the end, the skullduggery was brought about by because both sides needed to get past the issue.

What do I mean by "skullduggery"?

When the House was called to order, Arkansas Republican Rep. Steve Womack took the gavel and immediately called for a voice vote to pass the bill. Stating that there were no objections, he deemed it passed.

Womack said later he did not hear anyone object, but he admitted that he went “pretty fast, yeah.”

“I know the drill, I don’t have to read it, and I did what the presiding officer is supposed to do: I asked for a voice vote, and then two-thirds being in the affirmative, no call for a recorded vote, or the yeas and nays, bill is passed, motion to reconsider is laid upon the table, bang we go,” he told reporters.

Womack acknowledged that it was “unusual” to conduct business in that fashion, but he said that’s “because very few things go by voice in that chamber, particularly of that type of magnitude.”

Womack said he “wouldn’t go so far as to say” that he had a plan to speed through the pending business before anyone had a chance to ask for a recorded vote.

“I just know what I’m doing, that’s why I was asked,” he said.


The SGR should be repealed and other ways to save Medicare should be found. In the meantime, The most transparent administration in history has nothing on this "reformed" and "transparent" Congress when it comes to conducting business.



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