House snuck “doctor fix” through in Pelosi Plan debate rules

posted at 2:55 pm on November 13, 2009 by Ed Morrissey

Byron York catches Nancy Pelosi playing a shell game with Medicare reimbursement rates and ObamaCare.  Her Pelosi Plan used cost projections that assumed that previously-passed Medicare reimbursement rate cuts would come into effect.  However, unremarked by the media, Pelosi shoehorned the “doctor fix” into the rules bill that governed the debate on the overall bill, adding $210 billion in costs without acknowledging them in her plan:

Something unusual and largely unnoticed happened last week as Democrats pushed the national health care bill through the House. In a complicated, late-night maneuver, on a party-line vote, the House Rules Committee used the health bill to pave the way for a $210 billion increase in Medicare payments to doctors, without any money budgeted to pay for it. Congress then combined that $210 billion with a measure that would force lawmakers to exercise fiscal discipline — except when it came to the $210 billion.

It was a particularly slick move, even by congressional standards. With one vote, committee Democrats managed to propose spending a huge amount of money while also claiming to clamp down on spending. More importantly, they threw a very big bone to several physicians organizations, which badly want the increased doctor payments and to whom Democrats are deeply indebted for support of health care legislation. And at the same time, they gave cover to moderate Democrats, who are under pressure to support health reform but also fear the wrath of voters concerned about overspending. ….

Normally, when the Rules Committee creates a rule, it does so for a single bill. “One bill, one rule,” says a veteran GOP Hill aide. But when it came to the health care bill, Democrats took the unusual step of combining the health bill and the $210 billion physician payment measure in a single rule; they were worried the doctor bill might fail if it were considered on its own.

There are good reasons to consider the “doctor fix.”  Medicare reimbursement rates are already low enough to chase providers from the Medicare market.  The cuts that Congress passed would decrease an already low reimbursement rate by double-digit percentages, which would push many more providers into refusing Medicare patients.  That would have a cascading effect, as providers in the system would have longer wait times and probably have to cut corners on care in order to afford to service that market.

But even with that aside, the question remains on how to pay for the rescission of the cuts — and the dishonest approach taken by Pelosi squelched that debate.  She deliberately chose to hide the fact that she had added over $200 billion in additional costs with no offset in revenues or expenses elsewhere.  It makes the Pelosi Plan explicitly a deficit-buster, even if one credits the Utopian assumptions on  which its economics are built.

That will prove very problematic in the conference committee, because Harry Reid has already lost that option in a filibuster vote.  He will have to either make the doctor fix an explicit part of his bill, which means the CBO will score it as a deficit buster, or leave it out — which will force the AMA and other physician organizations to scream bloody murder.  When it comes to a conference committee, assuming that Reid can actually pass a bill, the same conundrum applies.  Include the doctor fix and bust the deficit, or exclude it and lose the doctors.

These are the wages of dishonesty, of course.


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SHOCK – she’s a liar, a sneak and a thief.

Merry Christmas to us.

gophergirl on November 13, 2009 at 2:57 PM

Medicare reimbursement rates are already low enough to chase providers from the Medicare market.

Starve the beast strategy?

WashJeff on November 13, 2009 at 2:58 PM

somewhere else in the bill is a way to claw back all that “big bone” that she threw them.

Boners.

ted c on November 13, 2009 at 3:00 PM

Funp.

LibTired on November 13, 2009 at 3:01 PM

…which will force the AMA and other physician organizations to scream bloody murder.

Things always seem to get testy at the federal government feeder trough.

WashJeff on November 13, 2009 at 3:01 PM

Merry Christmas, suckers.

lorien1973 on November 13, 2009 at 3:01 PM

I am looking at a room full of shoes……how many more will drop?

Starlink on November 13, 2009 at 2:58 PM

Donate them and save a job per pair of shoes.

WashJeff on November 13, 2009 at 3:02 PM

A lying shrew lied! Shocking!

SouthernGent on November 13, 2009 at 3:03 PM

Yea I heard about this after the bill passed. What I’m scared of is how much more garbage they put in this bill. Who knows what else is in this thing.

Brat4life on November 13, 2009 at 3:03 PM

She did well. Got the extra baton into the race, and managed to pass it to the next runner as well.

The Big Question: Why are we finding this out after, rather than before, the vote? What is it about our lawmaking process that allows this kind of thing to happen?

unclesmrgol on November 13, 2009 at 3:05 PM

that old bag has more lies than wrinkles

search4truth on November 13, 2009 at 3:06 PM

Too clever by half, I suspect.

I wonder how many of the Blue Dogs even knew what was going on when they voted for the rule? Pelosi just marched them way out on a very short plank.

Heckuva job there, Nancy…

rockmom on November 13, 2009 at 3:07 PM

Because it’s Fridays with Byron!

Abby Adams on November 13, 2009 at 3:07 PM

The way this bill is headed, I think we’ve got Imelda Marcos’ entire shoe closet ready to drop between now and the final vote.

teke184 on November 13, 2009 at 3:08 PM

If only there was some way we could’ve read the bill first, we would’ve seen this…

Maybe let the bill be read for 72 hours before voting on it?
Maybe put the bill on the internet so all could read it?

It’d be nice if Obama or Pelosi would make a campaign promise to allow that…

/s

Skywise on November 13, 2009 at 3:09 PM

You can’t hide this kind of stuff anymore in the age of the blog, Nancy. Cram it, you lying weasel.

OhioCoastie on November 13, 2009 at 3:09 PM

How does she sleep at night?…I mean, beside, in a coffin…

NickelAndDime on November 13, 2009 at 3:10 PM

As we approach Thanksgiving, I’m reminded of a scene from Planes, Trains, and Automobiles. In the scene, a state trooper stops John Candy and Steve Martin on an expressway, and Candy tries to convince the trooper that a clearly disabled vehicle is actually roadworthy. It’s a funny scene, but Candy’s lies are embarrassingly untrue.

Likewise, the Obama administration and the Pelosi and Reid houses are clearly disabled. The wheels have fallen off the executive and legislative branches of our federal government. It’s pathetic, and I’m waiting for the media and those sleeping in the public to finally take notice.

BuckeyeSam on November 13, 2009 at 3:10 PM

The AMA (a leftist organization that only represents 15-20% of physicians) was in favor of this, many physician groups who represent more physicians in the aggregate than the AMA opposed the “Dr. Fix”. It actually screws physicians in the long run.

Aviator on November 13, 2009 at 3:11 PM

I’m going to assume that this was why this awful bill was endorsed by the AMA.
Based on that assumption, why didn’t someone uncover these billions before passage? BillO is right. This country can not work without a functioning media.

ORconservative on November 13, 2009 at 3:11 PM

How does she sleep at night?…I mean, beside, in a coffin…

NickelAndDime on November 13, 2009 at 3:10 PM

Actually, I think it is a hyperbaric chamber.

Aviator on November 13, 2009 at 3:12 PM

How does she sleep at night?…I mean, beside, in a coffin…

NickelAndDime on November 13, 2009 at 3:10 PM

With both eyes open since she can’t close them.

txag92 on November 13, 2009 at 3:13 PM

I just heard a few minutes ago on Rush, a whole host of things will be taxed as medical devices, such as toothbrushes and tampons, to pay for this health care farce.

JellyToast on November 13, 2009 at 3:15 PM

What else would one expect from The Warden?

betsyz on November 13, 2009 at 3:15 PM

Yea I heard about this after the bill passed. What I’m scared of is how much more garbage they put in this bill. Who knows what else is in this thing.

Brat4life on November 13, 2009 at 3:03 PM

We’ll find out around 2014 I guess.

Asher on November 13, 2009 at 3:16 PM

When the media lies and deceives as the politicians do, then what recourse do we have except in elections. Then the politicians lie and deceive to get elected and the media supports their every move. There is a sickness emitting from Washington and it will infect our entire country. When leaders like Obama, Reid and Peloser are so corrupt and intellectually dishonest, how can our representatives look us in the eye and then march lockstep to their every whim?

volsense on November 13, 2009 at 3:17 PM

Just what I always wanted for Christmas, a huge, steaming pile of sh!t. Great, let’s just hope I don’t a matching set when the Senate votes.

Torch on November 13, 2009 at 3:17 PM

Get a matching set….damn, I even hit the preview button! Long day…….

Torch on November 13, 2009 at 3:18 PM

It’s little nuggets like this that make it all the more humorous when Democrats suggest that Congress doesn’t need to read the bills that they pass.

myrenovations on November 13, 2009 at 3:19 PM

Normally, when the Rules Committee creates a rule, it does so for a single bill.

Forget normal. Nothing at all is done normally anymore.
Here’s the new normal,, if the ObamaDemocrats think they can get away with it, they will do it. Period.

JellyToast on November 13, 2009 at 3:20 PM

I just heard a few minutes ago on Rush, a whole host of things will be taxed as medical devices, such as toothbrushes and tampons, to pay for this health care farce.

JellyToast on November 13, 2009 at 3:15 PM

Abortions will be free but condoms will be $100 each.

pedestrian on November 13, 2009 at 3:29 PM

I just heard a few minutes ago on Rush, a whole host of things will be taxed as medical devices, such as toothbrushes and tampons, to pay for this health care farce.

JellyToast on November 13, 2009 at 3:15 PM

Just like this government to stick it to you on both ends.

Aviator on November 13, 2009 at 3:31 PM

Pelosi and her corrupt cohorts have no interest in governing responsibly. All they care about is winning the “game” and amassing more power for themselves. So what if they destroy the country in the process? Let somebody else worry about those trillions of dollars of debt, right Nancy? The important thing is that you get to stand and smirk for the cameras as you savor your “victory.”

These people are traitors. We need a revolution, and quickly.

AZCoyote on November 13, 2009 at 3:32 PM

And in their eyes there’s something lacking
What they need’s a damm good whacking.

J_Crater on November 13, 2009 at 3:33 PM

How the hell can you pass laws in debate rules?

Enoxo on November 13, 2009 at 3:34 PM

Most ethical CONgress evah!!

Itchee Dryback on November 13, 2009 at 3:35 PM

Once we pry the gavel from your bony fingers, we’ll have to have thorough hearings about a lot of things, Nan.

marklmail on November 13, 2009 at 3:36 PM

Pelosi and her corrupt cohorts have no interest in governing responsibly. All they care about is winning the “game” and amassing more power for themselves. So what if they destroy the country in the process? Let somebody else worry about those trillions of dollars of debt, right Nancy? The important thing is that you get to stand and smirk for the cameras as you savor your “victory.”

These people are traitors. We need a revolution, and quickly.

AZCoyote on November 13, 2009 at 3:32 PM

It is interesting to me that many of the morons trying to shove this down our throats are not spring chickens. Ole Nancy is 69 years old. I guess they figure they won’t be around to see the worst of what they will have wrought. The question is why does she hate her grandchildren so much?

Aviator on November 13, 2009 at 3:37 PM

So as I understand it, she shanked Dingy. Too funny.

mr.blacksheep on November 13, 2009 at 3:39 PM

Nancy spent years watching Soaps, and getting into the deceit, high drama, and machinations that come with those duds. Now she lives it. No wonder she has such a dumb a$$ smile on her face all the time.

Do democrats that vote for this really know what to prepare for? Loss of wealth, loss of life, thru the health care bill, and abject poverty, depression, and dispair. Now tell me again why you want this so much, or do you truly believe you’ll be exempt from this?

capejasmine on November 13, 2009 at 3:39 PM

The question is why does she hate her grandchildren so much?

Aviator on November 13, 2009 at 3:37 PM

2 reasons, as I see it. First, they take up air, space, and give off c02. Second…they have something she desperately clings to. Youth!

capejasmine on November 13, 2009 at 3:41 PM

capejasmine on November 13, 2009 at 3:39 PM

I think Liberals believe the country will be able to absorb any abuse they heap on it. After all it has done so for many years. Morons.

Aviator on November 13, 2009 at 3:42 PM

Most Ethically Challenged Congress Ever!

rmgraha on November 13, 2009 at 3:46 PM

Ah but really folks, who is the smart one? We know about it now, but can do NOTHING!

katablog.com on November 13, 2009 at 3:57 PM

Billion here a billion there and no one is hanging for it…

But hey, dont buy your insurance and prepare to go to jail!!

Ya…

javamartini on November 13, 2009 at 4:05 PM

What a great time to want study and work to become a doctor. In a time we need more doctors and others in the health care field our government surely making high school graduates rethink their careers.

SC.Charlie on November 13, 2009 at 4:30 PM

But enough about Sarah Palin and her million selling new book and her going all over the country and visiting every brook and dale and being admired and followed by millions…
Oh LOOK, a puppy!
 
Silly lib, no cookie.

Blacksmith8 on November 13, 2009 at 4:31 PM

http://www.veteranoutrage.com

As the LIES become more and more complex
they dissolve into complete and utter Insanity..

This shows how utterly dishonest and full of liers our governemtn has become..

Hell by these standards the USSR and communist China
are more honest and open than the US congress ..

veteranoutrage on November 13, 2009 at 4:33 PM

Another example of the sunlight and transparency that Obama and Peelousy promised.

eaglewingz08 on November 13, 2009 at 4:35 PM

The dems are crooked on an Olympic scale…hope it bites them next November

JIMV on November 13, 2009 at 4:40 PM

Pelosi’s commie care.

Johan Klaus on November 13, 2009 at 4:44 PM

The goddamn dem libs are nothing but a bunch of sneaks, liars, charlatins and thieves. They’d sell their own mother out to advance their socialist agenda. Makes me wanna puke.

bannedbyhuffpo on November 13, 2009 at 4:54 PM

Just like this government to stick it to you on both ends.

Aviator on November 13, 2009 at 3:31 PM

Yeah, I just love that. A toothbrush has now been classified as a “medical device.” Therefor it will be taxed. Stock up on them now.

JellyToast on November 13, 2009 at 5:16 PM

I just heard a few minutes ago on Rush, a whole host of things will be taxed as medical devices, such as toothbrushes and tampons, to pay for this health care farce.

JellyToast on November 13, 2009 at 3:15 PM

Every medical device used in laboratory tests (such as needles and test tubes, for example) or in patient care (such as IV drips) will be taxed.

Ultimately, the tax is passed on as a fee in the patient’s bill. Regardless of what agency pays for that fee– public oor private insurance, the cost of health care will rise exponentially.

onlineanalyst on November 13, 2009 at 5:24 PM

Ultimately, the tax is passed on as a fee in the patient’s bill. Regardless of what agency pays for that fee– public oor private insurance, the cost of health care will rise exponentially.

onlineanalyst on November 13, 2009 at 5:24 PM

It might be in a free market, but the reimbursement will be throttled in some manner. If the hospital can’t break even costs will be cut somewhere or (for example) that procedure would not be offered in that hospital.

Aviator on November 13, 2009 at 5:40 PM

Jolly old Saint Pelosi is gonna leave doo doo in our stockings this year.

csdeven on November 13, 2009 at 5:43 PM

My God they have ALL GOT TO GO!
What a sac of liars.

2010 BIOTCHES!

Yellowdog12 on November 13, 2009 at 9:06 PM

Just another good reason, or two, why I couldn’t be married to Pelosi. I avoid liars and cheats the instant they reveal their compulsion. No second chances on this mental malady. If I was maritally tethered to her, I’d have been put in jail for her safety. How’s that for irony?

ericdijon on November 14, 2009 at 8:31 AM