Conservatives Are Not Finished Trying To Prevent Working Families From Getting Affordable Health Care

House Democrats, led by Nancy Pelosi and Steve Israel came close to rending their garments after the Republicans' 52nd vote to wreck the Affordable Care Act this morning. Pelosi boldly proclaimed that Republicans "are wasting their time using that as their electoral issue" and attacked them for wasting time. "We shouldn't be wasting time on this foolishness and recklessness," she told journalists. "The Republicans' fixation with destroying the health security of millions of Americans through their efforts to destroy the Affordable Care Act imperil the permanent doc fix, and that must stop." And she had Hoyer whip the caucus against allowing anyone to cross the aisle and vote with the GOP. Normally they encourage endangered Democrats in red-leaning districts to do just that. However, their efforts failed-- giving the anti-healthcare forces a 238-181 victory-- and a full dozen Democrats, all of them Blue Dogs and New Dems, skipped over to the Republican side to join in the 52nd effort to, in Pelosi's words, "destroy the health security of millions of Americans." The culprits are the usual suspects:

• Ron Barber (Blue Dog-AZ)- R+3
• John Barrow (Blue Dog-GA)- R+9
• Ami Bera (New Dem-CA)- Even
• Joe Garcia (New Dem-FL)- R+1
• Jim Matheson (Blue Dog-UT)- R+16
• Mike McIntyre (Blue Dog-NC)- R+12
• Patrick Murphy (New Dem-FL)- R+3
• Scott Peters (New Dem-CA)- D+2
• Collin Peterson (Blue Dog-MN)- R+6
• Nick Rahall (Blue Dog-WV)- R+14
• Brad Schneider (New Dem-IL)- D+8
• Kyrsten Sinema (Blue Dog-AZ)- R+1

The Senate won't take the bill up and, like the 51 other bills the Republican and their Blue Dog/New Dem allies passed to kill Obamacare, will never be heard from again. Unless, as is somewhat likely, the Republicans hold onto the House-- thanks, Steve Israel-- and win a majority in the Senate-- thanks, Guy Cecil/Michael Bennet. Then they'll pass the bills all over again in both houses and Obama will veto them, setting up a 2016 election cycle based on how Hilary's poll-driven teams decides the issue will play in the voting booth.

The otherwise pointless bill they passed today, according to the CBO, would delay the individual mandate by five years, which translates to 43 million uninsured people in 2018, It would increase the premiums for people with individual plans by something like 20%. And, worse yet, there's a hostage: a big one. The Republicans and their Blue Dog and New Dem allies tied the mandate delay to the annual must-pass "doc fix" for doctors participating in Medicare. Doctors are furious:

A bipartisan deal in Congress to spare doctors from recurring Medicare pay cuts was in jeopardy on Thursday, as Republicans ignored protests from physicians and moved forward with legislation that would use the so-called "doc fix" to undermine Obamacare.

Hundreds of thousands of doctors who participate in traditional Medicare face a 24 percent pay cut on April 1, as part of a 1990s initiative to restrain federal spending on the government healthcare program, which today serves nearly 50 million elderly and disabled people.

Doctors thought they would see a permanent fix this year after Republicans and Democrats in the House of Representatives and Senate agreed on a policy to replace the payment formula, known as the sustainable growth rate or SGR, according to lobbyists, congressional aides and analysts.

But efforts to seal the deal broke down over how to fund its $138 billion cost over the next decade, and the doc fix appeared to be in danger of political oblivion as Republicans in the House and Senate pursued legislation that would pay for a solution with money from President Barack Obama's signature healthcare reform law.

The sudden partisan character of the doc fix debate brought an unusual public rebuke from the American Medical Association, one of the most powerful lobby groups, representing 225,000 physicians.

"I am writing to profess our profound disappointment that a strong bipartisan, bicameral effort to repeal the Medicare sustainable growth rate has become a victim of partisan approaches," Dr. James Madara, AMA's chief executive, said in a Thursday letter to House Speaker John Boehner and House Democratic leader Nancy Pelosi.

"We renew our call for all parties to engage in good faith, bipartisan efforts to address the budgetary implications of this bill and enact it. We stand ready to work with you in this endeavor."

Other physician groups also expressed their displeasure over the partisan turn.

"It's a sad state of affairs," said Dr. Thomas Barber, a lobbyist for the American Academy of Orthopedic Surgeons, which represents 16,000 physicians.

"To see something that was supported by both parties get shanghaied into the partisan politics of the day is very frustrating," he said.

…Behind-the-scenes efforts to reach a deal on money quickly ran aground, with Republicans demanding that the money come from entitlement reforms to Medicare and the Medicaid healthcare program for the poor, and Democrats pushing for hypothetical savings from the wars in Iraq and Afghanistan.

The AMA, which has led more than 600 other physician groups in a lobbying effort to secure a permanent doc fix, says it is still hoping for a permanent solution this year. Analysts say some doctor groups are pressing lawmakers to agree to a shorter patch of only a months to sustain the opportunity for dialogue.

The AMA says there have been 16 temporary SGR patches so far, costing taxpayers $154 billion. Securing an agreement on the doc fix is one of the association's highest priorities.

Raúl Grijalva (D-AZ) and Keith Ellison (D-MN), co-chairs of the Congressional Progressive Caucus, were livid after yesterday's vote. They issued this statement on behalf of their members: "House Republicans have proven once again that they can’t be trusted when it comes to Medicare. Instead of taking this opportunity to pass a bipartisan agreement that finally fixes Medicare physician payments, Republicans decided to attack the Affordable Care Act and leave seniors wondering if this problem will ever be solved. Republicans need to bring a bill to the floor that doesn’t repeal health reform or force people with Medicare to pick up the tab. A proposal that shifts costs onto seniors would not be a real solution and may actually prevent them from getting care they need, which doesn’t serve physicians or patients. The Congressional Progressive Caucus looks forward to voting on a serious, bipartisan proposal. We insist on a solution that does not shift costs onto seniors. We want fair pay for doctors and fair rates for patients."