GOP senator: Medicare deal should be offset

A freshman Republican senator is urging GOP Senate leadership to take a tougher stand on the House Medicare “doc fix” deal, highlighting a split within the party that could hold up the bill’s passage.

Sen. Ben Sasse (R-Neb.) sent a letter to Senate Majority Leader Mitch McConnell (R-Ky.) on Monday urging Congress to find more ways to offset the bill, which repeals the sustainable growth rate (SGR) used to calculate Medicare payments to physicians. The bill would drive up the deficit by about $141 billion over 10 years.

“I believe that Congress should have sought to repeal the SGR in a manner consistent with the precedent of fully offsetting scheduled spending cuts,” he wrote in the letter provided to The Hill.

The bill passed the House with a resounding 392 votes last week, but Sasse’s opposition suggests a tougher path in the upper chamber.

The Senate will be under intense pressure to pass the legislation immediately when it returns from recess on April 13, already two weeks past the government’s deadline to extend Medicare doctor payments.

Fiscal conservatives, like Sasse, have insisted on offsetting more of the costs, while liberals have called for more funding on the children’s health insurance program (CHIP).

In his letter to McConnell, Sasse stressed that he is not opposed to repealing the “doc fix” formula.

“There is broad, bipartisan consensus that SGR reform is desperately needed, and make no mistake, I am part of that consensus,” he wrote.

Sasse described the House bill as a “missed opportunity to fix Medicare” and called on the Senate to take on long-term reforms to the program.

Concerns from Senate Republicans already held up consideration of the bill on Friday, the day before Congress entered its two-week spring recess. The Senate could only have taken up the bill Friday with unanimous consent, which McConnell said he did not have.

An aide to the Senate’s Democratic leadership team on Monday blamed Republicans for the delay, though an aide to Sasse said the senator said he did not try to prevent a vote on Friday.

GOP opposition within the Senate would be a blow for Speaker John Boehner (R-Ohio), who has spent the last several weeks personally negotiating the deal. In the end, fewer than 30 House Republicans opposed the deal, despite concerns that only one-third of the costs would be offset in the next decade.