President Barack Obama's health care plan has drawn criticism for failing to address rising costs. The administration says the Senate bill would reduce the budget deficit. But Republicans like Rep. Paul Ryan, R-Wisconsin, said at the health care summit that those estimates are based on "a bill that is full of gimmicks and smoke and mirrors." Ryan says the so-called doc fix is "the most cynical gimmick" in the bill.
The doc fix prevents a large reduction in annual federal Medicare fees for doctors. Ryan says, "It was in the first iteration of all of these bills, but because it was a big price tag and it made the score look bad ... that provision was taken out." Instead, it was put into a stand-alone bill.
"Hiding spending does not reduce spending," he says.
Fact Check: What is the status of the 'doc fix?'
– In 1997, Congress enacted a "sustainable growth rate" spending reform to keep Medicare spending in line with the growth rate of the economy. In 2002, that formula called for cuts to doctor's fees, but Congress delayed those decreases. Congress has delayed cuts annually since 2003, resulting in larger fee reductions being called for each year.
– This year's "doc fix" would prevent a 21 percent cut in Medicare payments to physicians. Supporters argue that this must be done so that doctors don't drop their Medicare patients.
– The most recent spending cuts went into effect on March 1. When the Senate passed a bill extending jobless benefits on March 2, it included language temporarily delaying the cuts until the end of the month. Sen. Max Baucus, D-Montana, tried but failed to eliminate the doc fix from the jobs bill.
– Opponents argue that removing the fix from the health care bill and creating an independent bill for it is simply an accounting trick to make the health care bill look like it costs less. They argue that the country can't afford it.
– According to the Congressional Budget Office, enacting the Medicare Physician Payment Reform Act of 2009, which passed in the House last November, would cost about $210 billion over the next 10 years. The Obama administration set aside $371 billion in the 2011 budget to prevent a reduction in Medicare physician payments.
– Senate Majority Leader Harry Reid, D-Nevada, has said in the past that he hopes Congress can pass a "multi-year" fix after health insurance reform is complete.
As of now, cuts in Medicare payments to physicians are temporarily delayed. A permanent solution for the the politically unpopular cuts is unclear.
– CNN's Caleb Hellerman contributed to this report.
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