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How Congress solved one problem but created another

Nancy Marshall-Genzer Sep 28, 2015
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Congress used to do a little dance each year called the “doc fix.” Every year, doctors treating Medicare patients faced a big pay cut. Every year, Congress passed a short-term fix. And mixed in with the fix was funding for other Medicare expenses, such as physical therapy or ambulance rides.

But there’s no fix this year, because Congress passed a permanent solution, locking in yearly raises.

“It really affects providers across the board,” said Tristan North, senior vice president of government affairs at the American Ambulance Association

The problem for North and others is funding for those other Medicare expenses, like $100 million for ambulance rides, wasn’t locked in. That left North scrambling.

“There’s a lot that Congress needs to address between now and the end of the year,” he said.

No kidding. Members of Congress have to pass a budget, a bunch of tax credits are expiring and they have to deal with the debt ceiling.

“Everything in Washington, when it’s done at all, is done on a temporary basis,” said Howard Gleckman, a senior fellow at the Urban Institute. “We pass tax legislation that lasts a year at a time. We do highway bills for three months at a time.”

Gleckman says partisanship is the main reason for this piecemeal budgeting. But there’s another reason too, according to Jack Pitney, a professor of government at Claremont McKenna College.

“Members of Congress keep issues alive so that interest groups will keep campaign coffers full,” he said.

Pitney says lobbyists who have to fight for funding every year have to keep up the campaign contributions to get the votes they need.

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