Conservative groups demand Congress pay for $200B ‘doc fix’

Leading conservative groups are pressuring Senate Republicans to support a major change to the House-passed “doc fix” bill that would require Congress to pay for the entire legislation.

The Club for Growth is telling all senators to support an amendment from Sen. Mike Lee (R-Utah) that would force Congress to cut spending or raise taxes elsewhere to offset the costs of the $200 billion bill.

{mosads}The amendment, which will need 60 votes to pass, would pose a huge challenge for House leaders, who had already carefully negotiated a compromise to end a recurring Medicare payment problem known as the “doc fix.”

Lawmakers have failed to resolve the doc-fix problem for nearly 20 years because of cost disputes — an issue that is again threatening the fate of the legislation.

Lee’s amendment would require the legislation to follow “pay as you go” budget rules that stipulate any spending increase must be paid for, unlike the House-passed bill, in which the bill’s costs are exempt from those rules.

If Lee’s amendment passes on Tuesday, it could force a rewrite of the House deal, which has already earned nearly 400 votes. The Senate is facing a tight timeline: the double-digit payment cuts to Medicare doctors will go into effect Wednesday if Congress fails to act.

Andy Roth, the vice president of government affairs for the Club for Growth, sent a “vote alert” to Senate offices on Tuesday warning that their stance on the amendment would be factored into the Club for Growth’s 2015 Congressional Scorecard.

“It is imperative that members of Congress not be allowed to rack up more and more debt, especially those who profess to be fiscal conservatives who believe in limited government. This amendment should be vigorously supported,” Roth wrote. 

Heritage Action, which also represents budget hawks, ramped up the pressure for Republican senators to support Lee’s amendment on Tuesday.

“By striking the [pay as you go] exemption, Congress would signal that they plan to live by the budget. If it fails, they’ve indicated they don’t plan to live by their own budgets,” Paul Winfree, a budget expert for the Heritage Foundation, wrote in a blog Tuesday.

Both the Club for Growth and Heritage Action, which carry considerable weight in conservative circles, had previously voiced strong opposition to the House version of the bill. Their support for Lee’s amendment could provide some political cover to GOP senators who want to end the doc-fix problem but want to avoid blame for raising the deficit.

Sen. Ted Cruz (R-Texas) has already declared that he would not support the House bill even if included Lee’s amendment, calling it an extension of ObamaCare.

The cost of the bill has also drawn sharp criticism from fiscal conservatives like Sens. Jeff Sessions (R-Ala.) and Ben Sasse (R-Neb.).

Sessions said from the Senate floor late Monday that the legislation isn’t paid for despite being told “by a number of people that it was paid for.” He told reporters after his floor speech that he was not sure whether he’d support Lee’s amendment.

Even with a half-dozen amendments considered on the Senate bill, aides to House leadership said they are expecting the bill to pass unchanged.

House Republicans overwhelmingly approved the measure late month, with votes from hard-core conservatives and deficit hawks. Boehner had pitched the bill as a win for conservatives because it offers the party’s first chance at entitlement reform since controlling Congress while offseting the costs in the long term.