(Bloomberg) — The U.S. House of Representatives voted to change the way doctors are paid for treating Medicare patients, giving Speaker John Boehner a second legislative victory following weeks of discord in his Republican caucus.
Lawmakers in both parties hailed the 392-37 vote as a breakthrough for a chamber often depicted as dysfunctional.
"I hope this bipartisan approach is contagious," said Democratic Rep. Jim McGovern of Massachusetts on the House floor.
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The vote, along with Wednesday's adoption by the House of its version of a fiscal 2016 budget, reflects a quick turnaround for Boehner from earlier disputes among Republicans that caused a near-shutdown of the Department of Homeland Security and forced some bills to be pulled for lack of support.
Unlike the budget measure, which was adopted solely with Republican support, the Medicare bill also represented the work of top Democrats, led by Minority Leader Nancy Pelosi of California.
The bill, H.R. 2, would replace Medicare's cost-containment formula for physician payments in place since 1997. Congress has listened to warnings that physicians might stop taking Medicare patients and voted 17 times to prevent the formula from forcing cuts in doctor fees. The existing formula would cut doctors' pay by 21 percent starting April 1.
The American Medical Association, the largest U.S. doctors' organization, has been lobbying for years to change the payment system.
Children's insurance
The measure also would include a two-year extension of the Children's Health Insurance Program past its current Sept. 30 expiration.
Representative Michael Burgess, a Texas Republican and a doctor, said on the House floor that the plan is the result of "careful, intricate, bipartisan negotiations."
"We coalesced against the constant threat of payment cuts," Burgess said, that "everyone agrees has got to go."
McGovern said, "This bill is not perfect. Nothing around here is perfect." Democrats wanted a four-year extension of the Children's Health Insurance Program. He also pointed to language that would restrict abortions at community health centers, though he said that wouldn't change current policy.
The Congressional Budget Office says the legislation would cost taxpayers $141 billion in its first decade, a price tag that would usually cause revolt among fiscal conservatives.
Still, an alternate CBO analysis said the measure would cost less than by simply freezing physicians' Medicare payments for the next 10 years.
The measure would save $70 billion by limiting or cutting some payments to hospitals and other health-care providers and requiring Medicare's most affluent recipients to pay more out of pocket.
Congress plans to take the next two weeks off, and the legislation doesn't have to clear the Senate immediately. The Centers for Medicare and Medicaid Services said it won't begin to pay April bills for 14 days.
When Congress has missed previous deadlines, it has retroactively increased physicians' Medicare pay.
With assistance from James Rowley and Alex Wayne in Washington.
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