Senators Nearing Deal To Pay For Doc Fix By Tweaking Health Reform

Jennifer Haberkorn has the scoop on a pending deal to pay for a one-year extension of the so-called doc fix, a legislative patch that would prevent scheduled pay cuts of 25% to physicians participating in Medicare:

The deal pays for the must-pass patch to prevent a deep cut in Medicare doctors’ payments with changes in the tax subsidy program that some consumers will use after 2014 to buy health insurance on the new exchanges.

Staff members representing Majority Leader Harry Reid, Minority Leader Mitch McConnell, Finance Chairman Max Baucus and Ranking Member Charles Grassley agreed to the deal, according to two Congressional aides and lobbyists familiar with the proposal….

The deal on the table would change how much money consumers would have to repay if their income status changes mid-year, pushing them out of the eligibility bracket. For instance, someone who qualified for a subsidy because he was unemployed in the first half of the year may have to repay a large portion of that subsidy if he finds a job. Few additional details were available Monday night.

In other words, individuals who qualified for subsidies at the beginning of the year (that is, they earned below 400% of the federal poverty line), but experienced an income boost that took them out of the eligibility levels, would have to repay more of the subsidy. The CBO estimates that this would raise about $19.2 billion that could be used to pay for the one-year fix.

The final details of the detail are still emerging and there are scattered reports that lawmakers are also looking to squeeze savings from the Medicare Improvement Fund and other tweaks to the health reform law’s exchanges. And while news of a doc fix is certainly reassuring, it is somewhat troubling to see lawmakers taking money out of the health care law and focusing on provisions that have not yet gone into effect.

In fact, with premiums only increasing and the economy still in recovery, changing the affordability standards — even in this relatively innocuous manner — is certainly not the best way to find pay-for dollars. Republicans will be eager to raid the ACA for savings in January and here are the Democrats helping them get started.


Merrill Goozner has more on on the compromise.

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