The bill increases spending by $17 billion over the next three years, offsetting the cost with cuts to health care providers. The authors of the bill employed considerable gimmickry to amass the cuts, however, and fully half of them don't appear for 10 years. For instance, the bill claims $5 billion in savings through a timing shift in Medicare cuts in 2024.
"We are going to put off until tomorrow what we should be doing today," said Sen. Tom Coburn, R-Okla., a critic of the bill. "It's a sham. ... It's nothing but gimmicks."
The bill also creates two new mental health grant programs, including $1.1 billion over four years for improvements to community health centers in eight states and $60 million over four years for outpatient treatment for people with serious mental illness.
The measure solves the fee schedule problem through next March.
Because of a flawed formula dating to 1997, Medicare doctors are threatened with big fee cuts almost every year. After allowing a 4.8 percent Medicare fee cut to take effect in 2002, Congress has since stepped in 16 times to prevent the cuts.