Doctors are sending white lab coats to Washington to protest a 21-percent cut in Medicare reimbursement rates taking effect due to Congress's ongoing failure to push through urgent, must-pass jobs legislation -- but there's still no guarantee that it will pass this week.
The pay cut to doctors who see older folks is just one of the many nickel-and-dime consequences of the latest episode of congressional dithering in the face of expiring domestic aid programs. It's the third episode this year, basically a rerun of the previous two, in which deficit reduction is pitted against the poor, old and jobless.
So far, according to data from the Department of Labor, 323,400 people who have been out of work for six months or longer have prematurely exhausted their unemployment benefits. By the end of this week, 903,000 will have missed checks. When the president finally signs the bill, benefits will be paid retroactively, but it's the long-term unemployed -- people who have spent half a year on $320 a week -- who are more likely to have dipped into savings and therefore least able to get by with no income.
An aide to Senate Democrats told HuffPost that Senate Majority Leader Harry Reid (D-Nev.) is looking for 60 votes to file a cloture motion as soon as tomorrow evening, setting up a final vote by the end of the week. It might not happen: Reid still needs to round up some Republicans and solidify support among Democrats. Sen. Ben Nelson (D-Neb.), for one, said last week he probably would not vote for the bill because of its deficit impact. Go-to Republicans Olympia Snowe (Maine) and Susan Collins (Maine) have both said they're against the bill in its current form.
And even if the Senate passes the bill this week, senators have already made changes to the version the House passed in May, meaning the House will have to vote again -- and the House doesn't like those changes. Rep. George Miller (D-Calif.), chairman of the House Education and Labor Committee, is unhappy the Senate Finance Committee chairman Max Baucus (D-Mont.) removed a provision in the House bill to require disclosure of 401(k) fees. And the deficit-wary House Democrats who stripped from the bill a $24 billion provision to help states with Medicaid will be unhappy that the Senate intends to put it back.
President Obama said in a letter to congressional leaders Saturday that the bill will prevent "massive layoffs at the local and state levels" and keep the economy from backsliding. But some deficit hawks in both parties think extended unemployment benefits are hurting the economy because unemployed people would rather live on the dole than look for work.
Asked last Thursday why the Senate is not moving with a little more urgency, Sen. Debbie Stabenow (D-Mich.) pointed out that the Senate actually passed a more deficit-heavy version of the bill back in March, and since then monthly reports from the Labor Department have continued to show modest job gains. "We had Republican support for the original bill but now we are finding less support from the Republican caucus," she said.
"We are concerned that unless legislation is enacted quickly, Medicare beneficiaries may find it exceedingly difficult to find a physician who will treat them -- problems that are likely to be heightened in rural areas," wrote AARP CEO Barry Rand in a letter to senators. "We have already heard from some of our members that they have had problems finding a physician who will accept Medicare patients."
The American Medical Association, physicians' top lobbyshop, says doctors across the country are declining new Medicare patients and cutting back on services for current ones because of Congress's mismanagement of funding for Medicare. Congress has passed a so-called "Doc fix" several times over the years to prevent a scheduled cut in payments to doctors taking Medicare patients. The AMA is annoyed that Congress flubbed the latest Doc fix and wants it to fix the underlying problem as well.
"Physicians want to care for seniors, but multiple short-term delays have created severe instability for physician practices nationwide," said AMA president James Rohack in a statement. "This is no way to run a major health insurance program."
UPDATE 5:30 P.M.
Senate Majority Leader Harry Reid (D-Nev.) filed for cloture on the bill Monday afternoon after rejecting a Republican attempt to bring up an alternative version paid for with unused stimulus funds. Reid will need 60 votes Wednesday morning to set up a final vote as early as Thursday.
Senate Minority Leader Mitch McConnell (R-Ky.) had asked for "unanimous consent" to move a bill providing a 30 day extension of unemployment benefits, Doc fix, and other programs. "30 days doesn't do it," said Reid on the Senate floor in response to McConnell. "It just kicks the ball down the road."
Democrats have criticized past attempts to use stimulus funds, which they say are already committed to future projects.
Since December, a series of 30- and 60-day last-minute extensions of the programs have made for a series of lapses in the programs as the Senate squabbled over the deficit. The lapses, however brief, nevertheless cause panic and confusion for recipients of unemployment benefits.
"This doesn't even pass the laugh test and it's insulting to people who are anxious to get their unemployment benefits," said Reid spokesman Jim Manley. "The Republican leader knows full well that his measure is doomed to failure because of a little thing called the Constitution that says all revenue measures must originate in the House."
"Weird, that's not the reason Sen. Reid gave for letting the unemployment benefits remain unpaid -- he said it was because stimulus spending was more important," countered McConnell spokesman Don Stewart. "But great, if the blue slip issue is their only concern, surely they won't object to us calling up a House-passed revenue bill and amending it with the 30-day extension so that people can get their benefits."