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Dem Memo: Mislead Your Constituents About ‘Doc Fix’ So as Not to Ruin Our Budget Talking Points (Update: Politico Withdraws Memo to Verify)

By Mary Katharine Ham
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Update: Here is the Democrat denial on this memo, and the Politico withdrawal notice. Let’s hope someone wasn’t freelancing fake memos around the Hill. Or worse, had some direction to do so. It would be ever so unhelpful if, in highlighting Dems’ budget tricks, Republicans get caught in a ridiculous trick of their own. No named Democrats or aides aren’t denying the memo yet. My guess is folks on both sides are less sure where it came from than the original report suggested, and they’re scrambling to figure it out now. Will update when I hear more.

Anyone following health care and its attendant budget gimmickry knows that something called the “doc fix” was removed from the health-care bill last year because its price tag—between $200 and $400 billion— shattered Democrats’ claims of deficit reduction and put the total CBO score over $1 trillion, which was not deemed politically palatable.

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That doesn’t mean it’s gone, of course. The “doc fix” will always be with us, and has remained with us throughout the year, simply passed by the House as a separate bill to keep its icky cost out of the health care CBO scores.

One of the American Medical Association’s top priorities is the “doc fix,” which would prevent cuts being made to Medicare payments, but it is supporting this version of the bill even though the “doc fix” is left out. Curious, no?

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 group is working behind the scenes with Democratic leadership and the White House to fix the cuts later this year.

The Democratic memo, in full, is here. Update: Democrats are crying “hoax”on the memo, first published at Politico. Quoted aides are all unnamed:

“We have checked with every Democratic office, no one has ever seen it. It did not come out of a Democratic office,” the aide said, adding that media outlets printing the memo have not checked with leadership offices if the memo is authentic. A second Democratic leadership aide confirmed the memo was not sent by the Democrats. A third Democratic aide also said the memo is fake, citing the “draft” stamp and saying no one uses such things.
“If this were a Democratic communications person who wrote this, they should be fired, because this looks like Republican talking points,” the third Democratic aide told TPMDC.

The language used in it is quite clear:

As most health staff knows, Leadership and the White House are working with the AMA to rally physicians support for a full SGR repeal later this spring.  However, both health and communications staff should understand that we do not want that policy discussed at this time, lest I [sic] complicate the last critical push for health reform.

And, further, representatives should not get into CBO details, lest smart constituents catch them in the “doc fix” trickery afoot:

The inclusion of a full SGR repeal would undermine the 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 Washington Post is calling nonsense on the numbers and assumptions Dems gave the CBO:

But perhaps the biggest risk that could cause the budget impact to diverge from the CBO estimates comes from Congress. The estimates assume that the legislation plays out as written over the coming decade, which would mean reining in the growth of payments to doctors and hospitals and implementing a tax on high-cost health insurance plans.
Those two policies are responsible for bringing in the revenue and cost savings that allow the plan to expand coverage to 32 million more Americans yet, according to the projections, bring down the deficit.
But that falls apart if a future Congress finds the cuts or taxes too painful to handle and overturns them.
There is precedent for that.

Indeed, there seems to be precedent before our very eyes.

Megan McArdle puts it more sharply:

6)  Ultimately, this rests on the question: are we really going to cut Medicare?  If we’re not, this gargantuan new entitlement is going to end up costing us about $200 billion a year next decade, which even in government terms is an awful lot of money.  There are offsetting taxes, but they’re either trivial or likely to be unpopular–look forward to a 4% rent increase when your landlord has to stump over the same amount for the new tax on rents.  Then look forward to repeal of same.
I think this is a fiscal disaster waiting to happen.  But no one on the other side cares, so I’m not sure how much point there is in saying that any more.

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