Democratic Shell Game

Excerpt:

Democrats are planning to introduce legislation later this spring that would permanently repeal annual Medicare cuts to doctors, but are warning lawmakers not to talk about it for fear that it will complicate their push to pass comprehensive health reform. The plans undercut the party's message that reform lowers the deficit, according to a memo obtained by POLITICO.

Democrats removed the so-called doc fix from the reform legislation last year because its $371-billion price tag would have made it impossible for Democrats to claim that their bill reduces the deficit. Republicans have argued for months that by stripping the doc fix from the bill, Democrats were playing a shell game.

“Most health staff are already aware that our health proposal does not contain a 'doc fix.' … The inclusion of a full SGR repeal would undermine reform’s budget neutrality. So again, do not allow yourself (or your boss) to get into a discussion of the details of CBO scores and textual narrative. Instead, focus only on the deficit reduction and number of Americans covered,” the memo, sent Thursday to Democratic staff, said.

“As most health staff knows, leadership and the White House are working with the AMA to rally physicians for a full SGR repeal later this spring. However, both health and communications staff should understand we do not want that policy discussion discussed at this time, lest (it) complicate the last critical push to pass health reform,” according to the memo.

The memo helps explains why the American Medical Association has supported reform even though their top legislative priority, the doc fix, was left out. The group is working behind the scenes with Democratic leadership and the White House to fix the cuts later this year.

Indeed, in a statement this afternoon, the AMA announced its support for the reconciliation bill -- and hinted that the debate is not over with reform's passage.

“This is not the last step, but the next step toward real health system reform. We will remain actively engaged with Congress and the administration to ensure that before Congress adjourns there are additional important changes to our health system," AMA president James Rohack said. "Congress must act to preserve access to care for seniors and military families by permanently repealing the Medicare physician payment formula that will cut Medicare payments by 21 percent next month.”

The memo also repeatedly advises Democrats not to discuss the details of the CBO score.

“We cannot emphasize this enough: do not allow yourself (or your boss) to get into a discussion of the details of CBO scores and textual narrative. Instead, focus only on the deficit reduction and number of Americans covered," the memo says

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