House Medicare bill gets veto-proof majority

In a surprise development, the House on Tuesday passed a Medicare bill with a veto-proof majority, marking a significant step toward a goal that has eluded Congress all year.

The measure passed on a 355-59 vote, with 129 Republicans joining all Democrats who voted to approve the bill. Several members of the GOP leadership cast votes for the legislation.

{mosads}The Democratic leadership set a high bar for passage by placing the measure on the suspension calendar, where it needed a two-thirds majority. As time ran out on the vote and it became clear it had reached that mark, at least 18 Republicans switched their “no” votes to “yes.” The margin also means that the House could override the presidential veto that the White House has threatened.

The House Republican leadership opposed the bill and whipped GOP members to vote against it.

Shortly before the vote began, Energy and Commerce Committee ranking member Joe Barton (R-Texas) predicted that Democrats had little chance of winning over many Republicans.

“We were not part of the process,” he said, adding, “There’s a 95 to 100 percent chance we’re going to be ‘nos’ regardless of the substance of the bill.”

In the end, more than enough Republicans proved him wrong, including Rep. Nathan Deal (Ga.), the chairman of the Health Subcommittee of Barton’s panel. House Republican Conference Chairman Adam Putnam (Fla.) and House Republican Policy Committee Chairman Thaddeus McCotter (Mich.) and Vice Chairman Michael Burgess (Texas), as well as several committee ranking members, also voted for the Democratic bill.

Passage of the Medicare bill is a victory for House Democrats, who dared Republicans to vote against it by taking it directly to the floor. This development also could strengthen the lower chamber’s hand in any forthcoming negotiations with the Senate, which has not passed its own Medicare legislation.

Though the legislative calendar in both chambers is crowded with high-profile items, the looming physician fee cut has created a sense of urgency. Lawmakers have been unable to agree, however, on how to offset the cost of the physician fee fix, estimated at $6.4 billion to $6.8 billion, whether to set aside new money for low-income beneficiaries and other issues.

The White House primarily objected to cuts Democrats propose to private Medicare Advantage health plans. Congressional Republicans have raised the same concerns.

In the Senate, Finance Committee Chairman Max Baucus (D-Mont.) and ranking member Chuck Grassley (R-Iowa) are engaged in negotiations over a compromise bill. They could announce a deal as soon as Tuesday, but the significant margin of passage in the House might create pressure on Democrats and Republicans alike in the Senate to take up the House bill.

The House bill, like the original Baucus measure, would forestall a 10.6 percent cut in Medicare payments to physicians, which will automatically take effect July 1 unless legislation is enacted. In place of the cut, the bill would hold payments at their current level for the rest of this year and establish a 1.1 percent pay hike in 2009.

The bill also incorporated bipartisan legislation to delay the implementation of a Medicare competitive bidding program for durable medical equipment, also slated to take effect July 1. That measure, sponsored by Reps. Pete Stark (D-Calif.) and Dave Camp (R-Mich.), had strong support from both parties, including the backing of Minority Leader John Boehner (R-Ohio).