WASHINGTON — Legislation giving doctors $247 billion in increased Medicare fees over the next decade veered toward collapse in the Senate on Tuesday, a victim of bipartisan concern over growing federal deficits.
Instead, key lawmakers worked privately on a far less costly bill that would avert a 21 percent cut scheduled to take effect on Jan. 1 and give physicians an increase of 0.5 percent in 2010 and 2011.
Sen. Kent Conrad, D-N.D., said he and Sen. Charles Grassley, R-Iowa, were discussing a possible compromise that would cost $25 billion over two years and — unlike the original measure — not raise federal deficits.
The nation’s debt “doubled during the last administration, and if we don’t do something, it’s going to double again in the next eight years,” Conrad said.
Anything less than the 10-year bill would mark a defeat for the American Medical Association, which has made a priority of legislation to create a new program to assure doctors reliable annual fee increases.
The organization has aired television commercials in several states at a cost of $1 million or more and dispatched top officials to the Capitol in recent days to lobby lawmakers.
“Congress needs to fix this problem once and for all,” the AMA’s president, Dr. J. James Rohack, said in a written statement at day’s end. “No more Band-Aids.”
The developments occurred as key lawmakers and White House aides met for the second straight day in the Capitol in hopes of agreeing on comprehensive health care legislation that can reach the Senate floor by the first week of November.
Participants in the talks said no decisions had been made about key issues, including proposals to allow the government to sell insurance as a means of holding down prices charged by private insurers.
President Barack Obama has made an overhaul of the nation’s health care system a top priority, and any legislation is expected to require most Americans to purchase insurance.
Lower-income individuals and families would receive federal subsidies to defray the cost, and small businesses would receive government help to pick up part of the cost of covering their employees.
Legislation also would include consumer protections such as a bar on the insurance industry’s current practice of denying coverage on the basis of pre-existing medical conditions.
The issue of paying doctors who treat Medicare patients has been a vexing one for years, and lawmakers of both parties have made a habit of penciling in deep future cuts to make deficit projections appear better than they really are.
The cuts never take effect, because lawmakers have always stepped in at the last minute to provide the funds necessary to avert them, and deficits rise accordingly.
Medicare already pays physicians less than private insurance companies, and the AMA says that without legislation, Medicare patients will be disadvantaged because fewer doctors will be willing to take care of them.
“We’re going to take care of the senior citizens and the doctors,” Senate Majority Leader Harry Reid, D-Nev., told reporters. “As I’ve indicated, it could be a one-year fix, it could be a 10-year fix, but we’re going to take care of them.”
