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House Republicans brought their 52nd bill to gut Obamacare to the floor on Friday, where it passed 232-187. That's the end of it, of course, as it's been with the 51 votes before it, because the Senate won't take up the bill. This one would delay the individual mandate in the law by five years, which would mean 43 million uninsured people in 2018 and increase the premiums for people with individual plans by as much as 20 percent. So says the CBO.

But that's not the most pernicious part of this bill, because this time they tied the mandate delay to a must-pass bill, the "doc fix" for doctors participating in Medicare. This is a patch that has been necessary since the 1990s, when Congress passed a flawed spending formula for Medicare reimbursements, making those cuts too steep. They're too steep this year—24 percent. And the cuts are scheduled to kick in on April 1. That's a huge problem for doctors and for Medicare patients, which makes it a perfect hostage for Republicans. That hostage-taking, however, has pissed off a lot of people, not the least of which are doctors.

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."

Yeah, right. They've got two weeks to come to that "good faith, bipartisan" effort that the Senate will accept, and one of those is the sacred St. Patrick's Day week-long recess. Because that's how Republicans do this, manufactured crisis to manufactured crisis.

Originally posted to Joan McCarter on Fri Mar 14, 2014 at 08:21 AM PDT.

Also republished by Daily Kos.

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