Roll Call: Latest News on Capitol Hill, Congress, Politics and Elections
February 8, 2016

House GOP to Tie ‘Doc Fix’ to Individual Mandate Delay (Updated)

(Bill Clark/CQ Roll Call File Photo)

(Bill Clark/CQ Roll Call File Photo)

Updated 5:33 p.m. | House Republicans will tie the “doc fix” to a delay of up to 10 years of the mandate in Democrats’ health care law that Americans purchase insurance, according to GOP aides.

Leadership has been looking for a way forward on the legislation, but have yet to find a politically safe way to offset the $130 billion price tag for the 10-year “doc fix.”

Majority Leader Eric Cantor, R-Va., had been reticent about moving the bill given the price tag, and as an opening salvo in negotiations, he will put on the floor a bill that would offset the cost from savings found by delaying the Affordable Care Act’s individual mandate.

The House passed a bill earlier this week delaying the mandate for one year. It was their 50th vote to repeal or otherwise take apart President Barack Obama’s key domestic policy achievement.

Ways and Means Ranking Member Sander M. Levin, D-Mich., said the bill will be a “road to nowhere” because the Senate will not agree to dismantle the signature law.

“There’s been no effort by them to sit down and talk about the pay-fors,” Levin said of Republicans. “So instead they’re pretending, and that may be understandable, but it’s inexcusable.”

The bill would shore up a formula that determines doctors’ payments when they treat Medicare patients. It expires at the end of the month, and the payments to the doctors would be drastically cut.

The Congressional Budget Office found that a one-year delay of the individual mandate would save $9 billion over 10 years. GOP aides said that to cover most of the cost of the “doc fix,” the mandate will be delayed for as much as a full decade. (Aides earlier had said the bill would be delayed 10 years but the legislation continues to evolve.)

During a weekly colloquy, Rep. Mike Conaway, R-Texas, who was standing in for Cantor, was asked whether the policy would extract savings from a delay to the individual mandate.

“The specifics of what the pay-fors are going to be are currently under discussion,” he said.

The news comes the same day as the American Medical Association swarmed Capitol Hill with representatives. They have made a long-term fix to the formula a priority.

Senate Finance Chairman Ron Wyden, D-Ore., said this week that he also wants to push a long-term fix.

  • ebola131

    The GOP is the “stoooooped” party.
    Stay away from anything “health care” related.
    Sue Barry anyway possible to enforce the crap sammich law.

    • sixerfixer1976

      Yeah, yet another exhibition of just how the Stupid Party can’t think in principles. Ironically, the next most corrupt president in U.S. history — U.S. Grant — understood how to get rid of Obamacare: “I know no method to secure the repeal of bad or obnoxious laws so effective as their stringent execution.”

      These brainy socialists think that state-run medicine is the answer, that it’s the only “moral” way to run a health-care system? Fine. Give ’em exactly what they rammed up our collective a$$es, good and hard.

      No delays, period.

  • Bo Tye

    Competition’s benefits are destroyed when groups, such as unions, are organized to interfere with competition by forcing membership.

  • WilliamK

    This is not a very good approach. The mandate is what is supposed to pay for expanded coverage. I know the whole ObamaCare math does not work, but this just makes it worse. Pay the docs and attack ObamaCare from the other angles.

    • evilsandmich

      I know the whole ObamaCare math does not work

      That’s not all that does not work with it. Anyway, if the math was all that important it seems that Big Zero would enforce all the provisions of the law instead of cherry picking in an effort to not have it (further) kill the economy.

  • Sencho

    “There’s been no effort by them to sit down and talk about the pay-fors,” Levin

    Funny, isn’t it? Democrats are only concerned about how they’ll increase taxes (pay-fors) here, not about people’s health or liberty.

    So the question for Levin should be simply, GOP will agree to have a sit down and talk about your ‘pay-fors’ if you’re willing to sit down and talk about outright repeal.

    Levin, your party failed with Jim Crow and Prohibition, why do you think this will work?

    • Rick Caird

      Just think of all the money we could save the government and the middle class if we just abandoned ObamaCare completely.

      • Sencho

        The less money the government has the less money people like Levin can steal.

      • Ulyssess

        Such a silly comment. Rick can’t see that Obamacare is the next big boom. If Rick was smart he’d Goggle who pays for Obamacare and discover it won’t cost him a dime. Rick is saying: “Instead of having a cavity filled, let’s wait until it needs a root canal.” I would think this one example would be enough to show how silly Rick’s posting is. I bet no body ever accused Rick of being smart.

        • Rick Caird

          You are kidding, right? At this point, ObamaCare is projected to cost about $2.6 trillion over the next 10 years. I know who is paying that: the taxpayers. The only stupid one here is the one that thinks someone else will be paying for it. (BTW way, it is Google, not Goggle. Maybe that is why you are getting bad information).

          Further, the money for those subsidies is coming from somewhere. It is not falling from the heavens as you seem to think. The young are being courted because ObamaCare wants them to overpay to subsidize the sick and older people. The ObamaCare policies cost substantially more (or they have huge deductibles and copays). ObamaCare is a huge expense as I said.

          Now, if you want to have a debate on this, I will be happy to take you apart and hand you your head back on a platter. However, in your case, discretion is the better part of valor, so you would be better off slinking away quietly.

          • Ulyssess

            Dear Goofball, we need more of everything, buildings, all manner of construction workers, janitors, physical therapists, nurses, all sorts of techs for respiratory tests, blood tests—schools, more medical devices, buildings for that—you get the picture? If you make over 250,000 as a couple, you’ll help pay for Obamacare, if you are wealthy your Medicare premium will be higher, if you don’t get health insurance your penalty monies go toward paying for Obamacare—many other charges also, but, like I said, it won’t cost you because, based on your posts, you don’t command much of an income. Your last paragraph is straight from Junior high, but it at least brought a smile.

          • Ulyssess

            Further, you failed to respond how you calculate the cost of filling a cavity for $100 is worse that a $1,200 root canal. Another example would be how wellness checks won’t save money versus your plan of just waiting for a crisis, then go to emergency—the cost of which would be passed on in higher premiums to the rest of us. Why you think parents not being able to take a sick child to a doctor until a full-blown staph infection takes from your calculations. over is the better way to go.
            As you can see, I’m coming after you, not slinking away.

          • Rick Caird

            I’ll just start with enough to keep you busy for a while if you actually want to do some research (which you don’t). The first CBO estimate on the cost of ObamaCare was based on the fact ObamaCare would collect taxes for 10 years, but only provide benefits for 6 years. Now that we have passed the initial 4 years, the costs and the revenue are both considered over 10 years. That is one reason the estimated cost has jumped from $.9 trillion to $2.6 trillion. But, there are other reasons.

            First, the nursing home coverage was dropped because it was never going to be justifiable. But, it was designed to collect a lot of front end revenue. When it was dropped, so was the revenue. Second, ObamaCare assumed it could foist the costs of the expanded Medicaid onto the states, but the Supreme Court ruled ObamaCare could not override the current Medicaid reimbursement, so states could and did opt out leaving the costs to the federal government. In addition, as Obama has modified ObamaCare he has cut revenues significantly. He has dropped the employer mandate, so that reduced penalty income and it forces more people toward subsidized care. That means increased costs to the Feds while reducing revenue. Next, the latest escapade allowing people to keep their non ObamaCare compliant policies further reduces penalty income from the individual mandate but, worse, will increase the costs of the risk corriders because people will move to ObamaCare policies if they need the community rating and the reduced cost of insurance if they are sick, but will stick with current policies if it makes more sense to them. So, more expense for ObamaCare with further reduced revenues.

            Now, I assume your dental example is really some round about way of trying to say the preventive care is cheaper than catastrophic care. Well, the Oregon study on Medicaid versus non covered patients showed that is simply not true. So, that example is wrong.

            Finally, when the CBO estimates ObamaCare will cost $2.6 trillion, that is after all the ObamaCare projected revenue is collected. So, no, the over $250K surcharges do not reduce that and does not pay for ObamaCare as you seem to think. In fact, the two surcharges for high income people are projected to raise $317.7 billion over 10 years. That is a small, small part of the total ObamaCare costs.

            Here, do you want your head back yet or do you need to be sliced up some more.

          • Ulyssess

            Just you bantering. Here’s the question you need to answer: Is Obamacare the law of the land? A subsidiary question is: Will Obamacare create a Democratic majority just as Social Security did? Yes and yes.

          • Rick Caird

            I can see you just gave up on the cost and who is paying issue. So, I give you your head back.

            Now, is ObamaCare the law of the land? Well, I would say no since Obama has managed to change it whenever he wishes and it appears he is now not enforcing more of the provisions than he is enforcing. What kind of “law of the land”is that?

            The reason Obama is not enforcing major provisions of ObamaCare is he knows, as do Democrats running for office in contested districts, that ObamaCare will eliminate the Democratic Senate majority and turn it into a minority. You are really dreaming if you think ObamaCare will create a Democratic majority since it is uniformly hated by the electorate and still losing ground.

            BTW, Social Security is underfunded by $134 trillion over the next 75 years. You can expect Democrats to blame everybody but themselves for Social Security.

          • Ulyssess

            BTW whether Social Security is underfunded or not, the question to ask is: Is it paying retirees? Yes. No body cares about why Obama is doing this or that, changing this or that. Obamacare is the law and, even if republicans took the Senate, Obama would veto any effort to repeal it. Give Obamacare three more years and it will be woven into the fabric of American-life. You seem a bit dense—I asked whether Obamacare would create a Democratic majority—it will, for perhaps decades—and you went into some tripe about it being underfunded. BTW Democrats will take credit—not “blame” for Social Security, as well as Obamacare. Gladly, it wins elections.

          • Rick Caird

            I always get a kick out of an idealogue and you certainly are one. Of course, SS is paying retirees. The question is for how long. The Detroit pension system is under funded. How long do think it will be paying retirees.

            Yes, people do care when Obama constantly changes ObamaCare and when he makes it even more fiscally bankrupt. The problem is that when Obama changes costs and revenues, he is doing Congress’s job and that is unconstitutional. But worse, what if President Rand Paul just declares ObamaCare unenforceable in 2017? That is no different than what Obama is doing. I doubt ObamaCare will last past 2016. As Obama keeps delaying the major portions of ObamaCare, it is clear it cannot be “woven into the fabric of American life”. LOL. We cannot pay for it and the people who are paying for it hate it. Obama can veto a repeal, but that is very short term. ObamaCare will fall.

            I explained to you why ObamaCare will not create a Democratic majority. In fact, it is more likely to cause a long term Democratic minority as this disaster will be forever associated with the Democratic Party. That is what will kill Hillary. She tried HillaryCare and if she runs for President, she will be tied to a catastrophic foreign policy and the catastrophe of ObamaCare. n Hillary is toast.

            It is clear to the younger generation that Social Security is unsustainable and it is clear the ObamaCare is a horrible deal for them. The is not material for decades of a Democratic majority. You have managed to delude yourself in multiple ways. But, enjoy your fantasies. Those fantasies may well be all you have to sustain yourself.

          • Ulyssess

            Social Security has been hearing the same “sky is falling” blather for almost eighty years, so just keep with that mime if it makes you feel good. Health-care premiums are the lowest in fifty years, and if you can’t see those Democratic campaign commercials screaming: “These ideologues voted fifty times to take away your and your childrens’ health insurance—be sure to vote Democrat,” then you’re not much of a visionary. Lastly, Rand Paul will be President when hair starts growing in the palm of your hand.

          • Rick Caird

            I do believe you are financial infant. Health car premiums are not going down. They are going up and anyone forced to an ObamaCare compliant policy is getting killed paying for coverage he does not need or want. A 50 year old male does not need maternity care nor does a 50 year old woman need prostate screening. Voting 50 times to take away ObamaCare, which even scares Obama, is being seen as a positive, not a negative.

            You also seem to think there will be some magic bullet to save Social Security. There is none. SS will collapse just like Detroit, and the soon to follow, Chicago. Wishing and hoping will not suddenly find $130 trillion.

            The message will be that Democrats cannot prevent themselves from bankrupting the country and your children by making promises they cannot honor. Soon, even the low information voters like you will recognize that. Notice, Texas has balanced budgets. The blue states like Illinois and California are teetering on bankruptcy. Therein lies the problem.

          • Ulyssess

            Raise the cap to “save” Social Security. So obvious that it’s only a matter of time. You seem like a guy that thinks he can bullsh-t the fans as well as the players, but the truth is, any medical procedure will break the bank if you don’t have good coverage—not some policy that quits when you most need it. So—Don’t Cry For Me, Argentina, if premiums or deductibles are higher than the old policy. Health-care costs a lot of money. I’m glad Obama got it on the board and that will be his legacy. Your guy’s legacy was to lie the country into a war against a country that did us no harm, actually, come to think of it, you share that legacy.

          • Rick Caird

            You are nothing more than a troll. I hit you with facts and you change the subject.

            You have no concept that the ObamaCare soup to nuts coverage is not applicable to most people and those people are much brighter than the government in terms of what they need. You seem not to understand what catastrophic coverage is for and why many people prefer to pay cash for ordinary medical expense and carry catastrophic coverage for the unexpected. That is the way auto insurance and home owners insurance works. You don’t carry insurance for oil changes, but ObamaCare forces you to do so.

            You are also do not understand the financing of SS if you think raising or eliminating the caps will do much. It will not when compared to $136 trillion in unfunded liabilities.

            You are either hopelessly uninformed (or misinformed) or you are just trolling. In either case, you are not worth another minute of time.

  • Alice Boxstrom

    The morality, liberty, and prosperity of a free country run contrary to the subjective decrees of the “interests of society” put forth by those quacks, charlatans, and academics who conjure up the ever-shifting mirage of collectivist illusions.

  • teapartyidiots

    They know this is going nowhere – it’s an opening bid.

  • teapartydoc

    Cut away like mad, guys. I’m so disgusted by my profession and organized medicine, I really couldn’t care less, anymore. What really needs to be done is to abolish licensing, which is the root cause of all this, and I don’t think people will even begin to consider this until things go totally to hell. I guess I’m becoming like one of those radicals in the Dostoyevsky novels, only a conservative/libertarian one.

  • s_c_f

    Yes, let the dems choose if they like the IM or the doc fix better. That’s what compromise is about.

  • Galileo2

    Even though the Doc payment mess up is 100% Democrat caused, in the end the GOP will get 100% of the blame thanks to the ‘unbiased’ mainstream press.

  • Tread7

    obamaTaxCare = SovietTaxCare

  • bittman

    In 2009 the Democrats were telling us they wouldn’t pass Obamacare if it cost a penny more than $1 trillion. They cut $716 billion from Medicare to pay for it while insisting that this cut would not negatively impact senior citizens. They also omitted the cost of the “doctor fix” discussed in this article. The Medicare portion was a definite lie as seniors will soon learn. Omitting the cost of the doctor fix was dishonest because if they don’t pass it, doctors will drop many of their Medicare patients. I am beginning to question how many other lies the Democrats told us about Obamacare just to get it passed.

  • Rob Erta

    While liberty provides principles that guide us toward what the law should be, democratic methods can help determine what the law will be.

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