From a New York Times news article about health care legislation making its way through Congress:
For years, Congress has had to settle for temporary patches to prevent deep cuts in Medicare payments to doctors, like a 21 percent cut scheduled to take effect April 1 if Congress does not intervene.
The House measure would permanently remove the threat of such cuts, and would require some higher-income Medicare beneficiaries to pay higher premiums, a change Republicans hail as a major reform.
Who are these "higher-income" Medicare beneficiaries? A section-by-section summary of the bill makes clear that the hit starts with seniors who have modified adjusted gross income (MAGI) as low as $133,501. Now that Republicans have identified anyone with income above $133,501 as part of the "rich" to be milked for more money to fund government spending on doctors (like Mount Sinai's $4.8 million cardiologist), what's to stop Democrats from using that concession to justify further tax increases on that group? Why do Republicans think it's fine to raise someone's Medicare premium based on their income, but not to raise their taxes? It seems like an awfully fine distinction.
The Republican "doc fix" bill, supported by Minority Leader Pelosi but apparently in trouble with Harry Reid and his Senate Democrats, runs to 263 pages. At this writing it doesn't appear to have been scored by the Congressional Budget Office, but no matter, because the bill's final provision provides that its budgetary effects are excluded from statutory "pay as you go" scorecards.