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 Senate Sends Debt Ceiling Increase to the House
 January 28, 2009, following the State of the Union Address last night the Senate passed legislation today to authorize a huge increase in the statutory ceiling on Federal borrowing after voting to impose pay-as-you-go (PAYGO) budget rules for the first time since 2002.  The PAYGO language was specifically incorporated to appease Democrats in the House which last year passed budget enforcement legislation to require offsetting tax increases or spending cuts for most new entitlement program spending or tax reductions.  

The Senate voted to raise the debt ceiling by $1.9 trillion to a total of $14,294 trillion.  By a vote of 60-40, Senators adopted an amendment by Majority Leader Harry Reid that would codify the PAYGO budget principle.  Reid’s Amendment would allow a permanent extension without offsets of the middle class tax cuts enacted in 2001 and 2003, a two year extension of current estate tax law and the Alternative Minimum Tax (AMT) and MOST importantly to the Non Commissioned Officers Association of the USA (NCOA) would create a five year extension of the MEDICARE doctor fix which will prevent cuts in Medicare payments to physicians.  The Doctor Fix stops the 21% reduction in payments to Medicare/TRICARE physicians scheduled to take effect March 1, 2010.  An NCOA grassroots Legislative Alert to stop the scheduled 21% reduction in doctor payments produced over 1,000 emails to Senators, Department of Health and Human Services, Department of Defense, and Department of Defense in a one day (January 27/28, 2010) window of opportunity.  

    The vote of 60-40 in the adoption of Senator Reid’s amendment is correct.  Senator Paul Kirk (D-MA) cast an affirmative vote since Senator Elect Scott Brown (R-MA), his replacement, has not yet been seated as a member of the Senate.  No Republicans voted for the amendment.

House Majority Leader Steny Hoyer has indicated that the Senate legislation including the STOPGO provisions and exclusions (stopping the Medicare/TRICARE 21% reduction for physician services) will go to the House floor next week.   

NCOA seeks the elimination of the Medicare/TRICARE reimbursement reduction and will continue all avenues of legislative possibility to deny the 21% reduction for physician services thereby ensuring access by America’s seniors and military family beneficiaries to medical care.   
      
    

 
 
 
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