The "doc fix" is the nickname for the legislation Congress has been passing for the past decade to avoid a sharp decline in doctors' Medicare payments. In 1997, Congress created the Sustainable Growth Rate, which pegged the amount of money budgeted to Medicare payments to the projected growth of the economy. However, soon after, health care costs began to far outpace economic growth, creating a shortfall in funding. Since 2003, Congress has passed short-term fixes rather than attempting to forge a long-term solution to the problem.
March 31st is the deadline for Congress to pass new "doc fix" legislation. Without a new patch, doctors' payments would fall 24%.
Passing the "doc fix" bill required a suspension vote, necessitating a 2/3 majority. However, many members in both parties opposed the bill as written. Democrats wanted a longer-term solution, rather than just another patch. Republicans opposed the additional spending.
So, the leadership of both parties bypassed their caucuses and passed the bill with an almost empty chamber:
The bill was supposed to come to the floor early Thursday morning, but the vote was postponed into the afternoon as Majority Leader Eric Cantor, R-Va., Majority Whip Kevin McCarthy, R-Calif., and other leaders huddled with members of their party in a room beside the House floor to try to round up support.
Republican aides said at the time that the bill would most likely be pulled from consideration because it did not have the votes. Yet emerging from the room, Cantor told reporters, “We’re still working on it.”
Cantor left the room briefly to meet with Minority Whip Steny Hoyer, D-Md. That’s when the two leaders, with the backing of their respective leadership and committee chairmen, struck an agreement to call for a voice vote on the House floor without objection, members and aides said. Earlier in the day Hoyer said he would have voted against the bill. House Minority Leader Nancy Pelosi, D-Calif., asked if she went along with the voice vote plan, simply said, “Yes.”
Several members of the Republican Doctor’s Caucus, a group of physician congressmen, said they would have voted against the bill. But in the meeting with their leadership, they signed off on the tactic to allow the bill to pass.
When the House was called to order, Arkansas Republican Rep. Steve Womack took the gavel and immediately called for a voice vote to pass the bill. Stating that there were no objections, he deemed it passed.
Womack said later he did not hear anyone object, but he admitted that he went “pretty fast, yeah.”
“I know the drill, I don’t have to read it, and I did what the presiding officer is supposed to do: I asked for a voice vote, and then two-thirds being in the affirmative, no call for a recorded vote, or the yeas and nays, bill is passed, motion to reconsider is laid upon the table, bang we go,” he told reporters.
Womack acknowledged that it was “unusual” to conduct business in that fashion, but he said that’s “because very few things go by voice in that chamber, particularly of that type of magnitude.”Many members of both parties have since expressed their displeasure as such overtly anti-democratic tactics.