In a 53-47 vote, the Senate Wednesday dealt what media reports are describing as a blow to President Obama's plans for healthcare reform. While the procedural vote concerned a popular Medicare bill to increase payments to doctors by $247 billion, the media coverage notes that many of the Democrats who voted against the bill expressed concern that the bill was not funded and simply added to the deficit.

        The New York Times (10/22, A25, Pear, Herszenhorn) reports that Democrats "lost a big test vote on healthcare legislation on Wednesday as the Senate blocked action on a bill to increase Medicare payments to doctors at a cost of $247 billion over 10 years." Senate Majority Leader Harry Reid (D-NV) managed to win "only 47" votes of the 60 needed for cloture, and he "could not blame Republicans," as 12 Democrats and one independent, Sen. Joseph Lieberman (ID-CT), were opposed. By "addressing doctors' fees in a separate bill, Senate Democrats could hold down the cost of the broader health legislation, keeping it within the limits set by President Obama," but Republicans "said it was a transparent ploy to hide the cost of a healthcare overhaul."

        The Los Angeles Times (10/22, Hook, Levey) likewise reports the "setback for Reid represented a warning about the unpredictable road ahead for the far more controversial and expensive propositions at the core of President Obama's healthcare overhaul." Senate Democrats also "delivered a clear and important message to the AMA that the organization's top priority cannot be included in the bill without jeopardizing an overhaul that many in the medical profession believe is critical to preserving the nation's healthcare system." The Washington Post (10/22, Murray) calls the vote "rare bipartisan agreement...as 13 Democrats joined all 40 Republicans to block a permanent repeal of Medicare's payment formula for doctors."

        The Hill (10/22, Bolton) says that Reid "blamed the American Medical Association (AMA) for giving him bad information on the number of Republicans expected to support the measure." But AMA President J. James Rohack said, "The reference to 27 votes was made well before S. 1776 was introduced and in the context of bipartisan health reform legislation."

        The Washington Times (10/22, Haberkorn, Rowland) reports the Senate "blocked an expensive change to the way doctors are paid under Medicare over concern about the mounting deficit, in what Republicans called the first defeat for President Obama's healthcare plan."

        CongressDaily (10/22, Friedman, subscription required) says, "Senate Republicans portrayed Wednesday's trouncing of a Democratic effort to invoke cloture on a bill to fix a Medicare payment formula for physicians as an early win in their effort to defeat healthcare reform legislation." In fact, several "Republicans suggested Reid pushed for the cloture vote even though he knew he would lose as part of an agreement that AMA and AARP would back the larger health bill."

        Reid vows to find "new solution" to Medicare physician payment issue. Bloomberg News (10/22, Rowley, Jensen) reports, "Democrats are looking for a new solution so they can hang onto the support of doctors and seniors for the broader healthcare legislation." Sen. Reid said, "We're going to take care of senior citizens and the doctors, whether it's a 1-year fix, or a 10-year fix." Bloomberg adds, "In the Medicare-reimbursement issue, doctors say they are already underpaid by the federal program, and many refuse to see those patients as a result. Without a permanent solution that averts further cuts, seniors will have a difficult time finding care, said David Sloane, a vice president at AARP, which represents 40 million seniors."

        Similarly, CQ Today (10/22, Armstrong, subscription required) reports that "AARP said the Senate's failure to act could threaten seniors' ability to see the doctor of their choice by making physicians more reluctant to serve Medicare patients." Notably, "Senate Democrats are trying to blame Wednesday's 'doc fix' vote on Republicans -- and taking pains to assure the two powerful lobby groups pushing the bill that it will be revived and passed." But, "AARP portrayed Wednesday's developments as a failure caused by Democrats and Republicans."

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