Illustration: Gabriella Turrisi/Axios
A Medicare physician payment fix will be addressed in reconciliation, House GOP leaders said Tuesday, potentially complicating the budget math but also addressing a key health constituency's biggest concern.
Why it matters: Doctors hit with a 2.8% payment rate cut this year lost their bid to include a "doc fix" in the stopgap funding bill that's due to go to the floor Tuesday.
- Now, leadership will have to find billions of dollars in additional payfors in reconciliation, a promise of future action that leaders gave as they seek votes to pass the latest CR.
What they're saying: "We're gonna have a doc fix in the budget reconciliation bill," House Majority Leader Steve Scalise told Axios on Tuesday. "It's something that we need to get done and that's the right place to do it. And ideally more than just a one-year fix."
- GOP Doctors Caucus Cochair Greg Murphy told reporters Tuesday that he and leadership had discussed time frames of "at very least, obviously, this year, but the intention is to try to find enough money to make it at least permanent, or at least for five or 10 years."
- Murphy, who has been one of the leads pushing for the doc fix, acknowledged that the policy would add pressure on Republicans at a time when the caucus already is looking at Medicaid cuts to pay for an extension of tax cuts.
- "We'll have payfors," Murphy said, without elaborating." This is what the president wanted, and this is the best way that they feel like it could work."
By the numbers: CBO estimated for this fiscal year that just averting 2.5 percentage points of the 2.83% payment cut that took effect in January would cost $1.9 billion, according to a health care industry source.
Between the lines: There's a long way to go before a final reconciliation bill, so we'll be watching to see how leadership's promise plays out.
- A one-year fix would be easier to pay for, considering that a longer-term solution also could include annual payment increases to account for inflation.
- But doctors have the ear of some GOP lawmaker-physicians, who've been advocating for a long-term plan to make a perennial problem go away.
- That could give the doc fix a leg up over other stalled health care priorities from the discarded December health package, such as hospital payment reform or an overhaul of PBMs' business practices.
Our thought bubble: The new strategy means the doc fix happens only if Republicans can get a reconciliation package across the finish line — a big if.
What we're watching: It's not at all certain that the House will pass the CR.
- Several GOP lawmakers have said they're undecided on the stopgap measure, citing issues with not cutting funding levels further.
- House Democratic Leader Hakeem Jeffries has said Democrats won't be voting for the bill.
- "We'll see," said House Appropriations Chair Tom Cole. "I don't think you really know until you get to the floor. I know a couple of members are still struggling with this, but you know, if you're a Republican member, do you really want to shut down the Republican government?"
