House conservatives blast $200B plan

Conservatives in the House are assailing a $210 billion legislative fix for Medicare, warning the deal Speaker John Boehner (R-Ohio) is negotiating with Democrats could undermine the push for a balanced budget.

Some hard-liners in the GOP conference on Tuesday said they were infuriated to learn that Boehner had been talking for weeks with Democratic leaders about a plan to eliminate the automatic cuts to Medicare providers.

{mosads}“[Boehner] didn’t come to us and say, ‘How do we fix the ‘doc fix’ working with Mitch McConnell?’ He went to Nancy Pelosi,” Rep. Tim Huelskamp (R-Kan.) said Tuesday.

Rep. Jim Jordan (R-Ohio), chairman of the conservative House Freedom Caucus, said he is worried about offsetting the costs of the bill.

“They’re doing some savings, they’re doing some changes. You do like the idea of that long-term,” Jordan said. “But I am very concerned, obviously, about the long-term costs, the quote ‘unpaid-for’ part.”

The criticism doesn’t end with conservatives. Some liberal Democrats, as well as the AARP, are taking issue with the plan because it asks some seniors to pay more under Medicare.

Boehner briefed members about plans to repeal the formula, known as the sustainable growth rate (SGR), for the first time Tuesday. While he did not offer many details, sources in the closed-door caucus meeting said the plan was “received fairly well.”

Rep. Cathy McMorris Rodgers (R-Wash.), the fourth-ranking House Republican, said members appeared open to the legislation.

“I think they’re encouraged to see that there’s some movement on the entitlement side and how it relates to Medicare moving forward, and doing some things that are actually going to shore up Medicare,” Rodgers said.

The legislation would end a decades-long debate about how to compensate doctors under Medicare, an issue that Congress has put off over the years with 17 temporary “patches.” Nearly all in Congress agree that repeatedly punting the problem has cost taxpayers more money, but consensus on the solution has proved difficult.

Several Republicans, including some centrists, believe Boehner’s plan could finally end the impasse while also opening the door to bigger reforms of Medicare.

“If there is some entitlement reform in there that will be long-term, I’d be real interested to see that,” centrist Rep. Frank Guinta (R-N.H.) said after the meeting.

Some conservatives have also voiced support for the plan, such as Rep. John Fleming (R-La.), the co-chairman of the GOP Doctors Caucus. 

The biggest sticking point is how the GOP can keep its promise to reduce the deficit while advancing costly new legislation. Boehner will argue that while the deal is not fully paid for over the first 10 years, it will save money down the road.  

Rep. Raúl Labrador (R-Idaho) dismissed the plan as “a new trick that is promising future savings.” He noted the push to repeal the SGR is coming at a time when House Republicans are promising to balance the budget.

“That seems incongruous to me,” Labrador said. “Right now, I’m not very excited about the bill.”

While the details are in flux, the emerging deal would offset $70 billion of the slightly more than $200 billion price tag, with the cost roughly split between Medicare beneficiaries and providers.

On the beneficiary side, the plan would increase “means testing” for people enrolled in Medicare. Senior citizens making more than $133,000 a year would be asked to pay more. One income bracket would pay 65 percent of premium costs, for example, up from 50 percent.  

Those changes are riling some liberals and advocacy groups. In a letter to lawmakers on Tuesday, the AARP sad it opposes the emerging agreement because it is “not a fair deal for America’s more than 50 million Medicare beneficiaries.”

“We remain optimistic that we’ll be able to negotiate with House leadership and get a better deal for seniors,” said Ariel Gonzalez, the AARP’s health advocacy director.

House leaders appear open to at least one change: a proposed $250 deductible for some supplemental Medigap coverage has been reduced to $147, Gonzalez said.

The proposed new rules for Medicare have disturbed some Democrats, though Pelosi (D-Calif.) said Tuesday that the party has not yet received a formal briefing on the plan.

“I couldn’t support another tax on our seniors,” said Rep. Keith Ellison (D-Minn.), co-chairman of the Congressional Progressive Caucus. “I think there would be a lot of people concerned with hitting our seniors, $250, I don’t think that would go over very well. So I think it’s an uphill climb.” 

Boehner went against the grain on the Medicare issue last year, suspending the House rules in order to pass a temporary patch for the SGR by a simple voice vote.

This year, Boehner has chosen to craft a bill with the House minority leader instead.

Still, House Minority Whip Steny Hoyer (D-Md.) said the deal wouldn’t be a complete victory for Democrats. The current plan would extend the Children’s Health Insurance Program (CHIP) for two years, versus the four years preferred by liberals.

“There’s no doubt that whatever emerges wouldn’t be exactly what we would pass if we were in charge,” he said Tuesday.

But Hoyer said he’s also optimistic that a bipartisan deal will emerge by the end of the week.

“It’s a work in progress. And I’m hopeful that we will get to a place where we will have a bill that is a good bill,” he said.

— Scott Wong and Mike Lillis contributed.