House Speaker John Boehner (R-Ohio) has once again disregarded the conservative arm of the Republican Party and will forge ahead with two items that will increase the federal budget deficit. Boehner intends to drive a defense spending increase and the so-called “doc fix” through the United States House of Representatives over the next week.
Boehner’s agenda comes out of a deal he struck with House Minority Leader Nancy Pelosi (D-Calif.) to advance a bill that would permanently correct the reimbursement rate for Medicare physicians.
A “doc fix” refers to the practice of Congress updating physicians’ fee schedules and Medicare reimbursement rates to keep Medicare spending within a Sustainable Growth Rate, or SGR. This is done, ostensibly, to ensure that growth in Medicare spending does not exceed GDP growth. Physician groups have lobbied for a permanent “doc fix” so that reimbursement rates will not be subject to (potential) annual cuts.
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“The bipartisan, bicameral bill seeks to end the cycle of annual ‘Doc Fix’ crises that have created uncertainty for millions of Medicare providers and beneficiaries for over a decade and also create a system that promotes higher quality care for America’s seniors,” a March 19 release from committee leaders in both parties stated.
When questioned on his decision to strike a deal with the Democrats before discussing it with members of his own party, Boehner said, “I just think that there was an opportunity that presented itself to work in a bipartisan way to find the appropriate offsets, spending offsets…. And the door opened, and I decided to walk in it. As simple as that.”
The deal represents a fundamental shift of opinion for Boehner who, during a 2009 debate on Obamacare, denounced Democratic efforts to enact a “doc-fix.” Back then, Boehner said, “This irresponsible ‘doc fix’ proves once again that out-of-touch Washington Democrats simply cannot help themselves when it comes to piling debt on our kids and grandkids. Democrats continue to add tens of billions of dollars to the deficit while promising to eventually end their unprecedented spending binge.”
According to CNN, the price tag for the bill is $200 million, of which only a third is offset by cuts.
Boehner has also decided to increase defense spending by $20 billion without corresponding cuts following an intense budget dispute among members of the House Budget Committee.
Politico contends that Boehner’s actions signal his determination to take charge:
Whipsawed over the past several years by its rank-and-file, especially the most hard-core conservatives, GOP leaders appear determined to take charge. Boehner and [House Majority Leader Kevin] McCarthy have divvied up responsibility for the two major pieces of legislation. Boehner is working to ensure passage of the so-called “doc-fix” package, while McCarthy is overseeing work on the budget resolution, said GOP leadership aides. The leadership even was prepared to take control of the budget, if new Budget Committee Chairman Tom Price (R-Ga.) resisted changes to defense spending.
Some conservatives are confused as to whom Boehner is trying to assert his authority over, as he seems to have drawn a line in the sand in more dealings with his fellow Republicans than with the Democrats and the president.
Representative Tim Huelskamp (R-Kan.), an outspoken critic of Boehner, referred to Boehner’s “joint speakership” with Representative Pelosi, pointing to the latest deal on the doctor reimbursement issue as well as the recent compromise over funding for the Department of Homeland Security.
Earlier this month, Republican efforts to block funding for Obama’s executive action on immigration came to an end when Senate Majority Leader Mitch McConnell (R-Ky.) and Boehner caved and offered Democrats a clean funding bill. As a result, Speaker Boehner told his colleagues that they were out of options, and the House accepted the bill.
Boehner said at the time, “Unfortunately, the fight was never won in the other chamber. Democrats stayed united and blocked our bill, and our Republican colleagues in the Senate never found a way to win this fight.”
Republicans in the House were demoralized by the loss. One House Republican called it “an unmitigated loss for conservatives.”
Boehner also turned to Pelosi earlier this month to help pass the Passenger Rail Reform and Investment Act despite heavy opposition from his fellow Republicans.
The Passenger Rail Reform and Investment Act authorizes $7.2 billion in spending on Amtrak and other rail programs through 2019, a price that conservatives say is simply too high.
Following the Amtrak vote, Representative Huelskamp opined, “Who is really running the floor over here? John Boehner has lost control of the House. He has to call Nancy Pelosi.”
Republicans have expressed frustration at what they view as weak leadership.
“We were hoping to move everything to the right,” Representative John Fleming (R-La.) told the Washington Examiner after casting a “no” vote on the bill. “Looks like to me they are moving it to the Left. They’ve given up on us so they are going to the Democrats to get votes.”
“We are forgetting our core principles as a party,” Representative Walter Jones (R-N.C.) warned, as he headed in to vote against the bill. “And I think you need to lead with those core principles. If Boehner continues to reach out to Democrats to pass legislation, it’s going to continue to divide the party. Not just here, but across the nation.”
With Boehner pushing ahead with more spending items next week, Huelskamp argues that Republicans cannot claim to be fiscally conservative as long as spending continues to rise under their leadership. “Talking to some of my fellow conservatives, I said, ‘How do we tell Democrats we’re serious about cutting spending when our spending will bulk up when we’re going to cut their [programs]?’” Huelskamp said. “My worry is that … we’re going to break open the budget caps. That’s what we’re doing.”
Another Republican, Representative Tom McClintock of California, opined that Boehner should have been able to find some area wherein cuts could have been made to compensate for the increase in defense spending. “It’s a $3.8 trillion budget,” said McClintock. “We ought to be able to find $20 billion to cut somewhere.”
Similar sentiments came from Budget Committee panel member Marlin Stutzman (R-Ind.), a self-proclaimed “defense hawk.”
“Our responsibility, as a defense hawk myself, is to fund the military but also to pay for it by offsets,” said Stutzman. “We can find a way to pay for $20 billion.”
Meanwhile, Senate Republicans are working on a budget that is similar to the House version. After adopting an amendment from Senator Lindsey Graham (R-S.C.) to add $38 billion in emergency war spending, the Senate Budget Committee approved the budget in a party-line vote.
