Democrats’ Dishonest Doc Fix Dodges Deficit

Only with stripped provisions does the healthcare bill's cost look good.


By Peter Roff, Thomas Jefferson Street blog

Under a fig leaf provided by the non-partisan Congressional Budget Office, Speaker Nancy Pelosi and the Democrats who run the House of Representatives are trying to pull a fast one where healthcare reform is concerned.

Back when he spoke to a joint session of Congress, President Obama outlined his vision for a healthcare reform bill that, while he has yet to put anything to paper that has been released to the public, promised a deficit-neutral outcome. None of the three bills currently before the House met that criteria, in no small measure because the so-called public option is a budget buster.

Lo and behold, the CBO has just produced a preliminary estimate that the latest version of the House bills it has examined would, from a cost perspective, come in just under the wire at $871 billion over 10 years, a figure just inside Obama's $900 billion target. And, said CBO, it would reduce the total federal deficit by forcing reductions in the cost of healthcare all around.

Except these are, in the macro perspective, dishonest numbers.

What Pelosi is proposing to do, and what Senate Majority Leader Harry Reid of Nevada tried and failed to do Wednesday, is strip provisions out of the healthcare reform package that freeze cuts in payments to doctors that are mandated under current law and take them up as a separate piece of legislation that would, therefore, not count toward the healthcare reform bottom line.

The bill, the Medicare Physicians Fairness Act—which on Capitol Hill is also being called the "Doc Fix"—would cost the federal government nearly $250 billion over 10 years which, when it was part of the healthcare bill, boosted the cost well above what Obama told Congress he could accept. As Senate Republican Leader Mitch McConnell of Kentucky said Wednesday in opposing it, the payments freeze as currently constructed is just "another quarter of a trillion dollars on the federal credit card."

Without the freeze, doctors would see their Medicare reimbursements drop by 21 percent in 2010 and by 40 percent by 2016. So passing it, in healthcare reform or outside of it, is seen by congressional Democrats as something that is essential if the final bill, whatever it says, is to win the support of the American Medical Association.

More than that, the move to separate out the "doc fix" from the overall reform package has provided yet another lightening rod for critics of Obamacare. As conservative healthcare expert Peter Ferrara puts it, "For the Democrats to put the supposed fix for payments to doctors and hospitals in a separate bill and call the original health overhaul bill deficit neutral is an unprecedented legislative fraud on the American people."

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