Weeks of partisan fighting came to their expected end on Thursday night, as a bill to freeze a 21.2 percent cut in Medicare payments to doctors and extend jobless benefits until the end of May passed both houses of Congress and was signed into law by President Obama.

The $18 billion bill, H.R. 4851, passed the Senate 59 to 38. As with other votes on the bill, the final ones split along party lines, with only four Republican Senators voting in favor of it.

After passage by the Senate, the bill was sent to the House for final approval, where at around 8:00 pm by a vote of 289 to 112, it was forwarded to the White House to become law. Only one House Democrat, Rep. Jim Cooper from the 5th district of Tennessee, a Blue Dog Democrat known for his fiscal conservative streak, stood against it.

Democrats largely supported a bill they saw as helping the hundreds of thousands of unemployed due to lose their unemployment checks, but Republicans opposed the nearly $18 billion in spending that wasn't offset by cuts elsewhere in the budget and would add to the nation's $12.8 trillion deficit.

Because of an amendment attached to the bill this week by Sen. Max Baucus (D-MN), the cuts to Medicare physician payments won't go into effect until June 1. However, another bill, the American Workers, State and Business Relief Act of 2010, could delay the cuts until September 30. The Senate and the House have passed different versions of this bill, which they must still reconcile.

Many doctors' groups seek a permanent repeal of the Medicare cuts, which have been delayed by Congress every year for the past seven years.

"It's irresponsible to continue short-term fixes just as baby boomers begin aging into Medicare next year. Congress needs to make the better fiscal decision and the better decision for seniors and repeal the formula now instead of putting it off again and increasing the price tag for America's taxpayers," said J. James Rohack, M.D., president of the American Medical Association, in a statement.

The Medicare pay cuts are derived from a law that requires Medicare reimbursements to keep in line with the growth of the gross domestic product. It's believed a permanent repeal of these cuts would cost $200 billion over the next decade.

While physicians' advocates made the most of the Medicare cut freeze, politicians largely talked up the extension of COBRA health insurance subsidies and unemployment checks, which expired earlier this month for some of those out of work.

"In passing this bill and sending it to the president, we have succeeded in putting the emergency economic needs of everyday Americans ahead of the political interests of some Republicans, who had decided to delay at the expense of families trying to make ends meet," House Speaker Nancy Pelosi (D-CA) said in a statement.

(See also DM 12285, DM12121.)

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