Wednesday, February 12, 2014

Clean Debt Ceiling Passes House, SGR Remains in Limbo

After weeks of negotiations, House Republicans moved Tuesday evening on a debt ceiling agreement that does not include external policy riders, forgoing a potential short-term patch to the sustainable growth rate (SGR). The Senate is expected to vote on the legislation Wednesday.

The so-called “clean” debt ceiling increase is a departure from previous attempts by the House GOP to create a policy that will address the debt ceiling using only Republican votes while achieving conservative pet projects such as the keystone pipeline or Obamacare changes. Policies such as an SGR patch and an increase of military pensions were mulled as ways to sweeten the deal for House Republicans.

The Senate still needs to act on the legislation today. House Leadership took an approach that will ease the effect of procedural hurdles in the upper chamber, inserting the increase in an already passed Senate bill.

The move bodes well for those who hope to see the SGR permanently repealed and replaced this year. Many worry that another short-term patch, or “doc fix,” would interrupt the momentum that reform efforts are gaining. Last week, a final SGR replacement policy was agreed upon, though financial offsets and Medicare extenders have not yet been finalized.

The agreement on the debt ceiling comes as another act of bipartisanship following other key compromises on last year’s budget and debt ceiling extension. Among some, memories of the 16 day government shutdown and its political fallout still linger. Sources say House Speaker John Boehner (R-OH) was happy the concession got the “monkey off [Republicans’] backs.”

Others still were more candid about some of their rationale for the compromise. Senate Republicans are concerned with “getting the hell out of town,” according to one GOP Senator. The Nor’easter dubbed “Winter Storm Pax” has the potential to dump double digits of snow on D.C. early Thursday. The House started recess for the President’s Day work week and the Senate will be following the conclusion of legislative business today.

AHCA staff will do our best to brave the storm while we prepare for more SGR negotiations over offsets and extenders. Congress will have to act by March 31 to prevent physicians’ from receiving a 24% cut in their Medicare reimbursement rates. 

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