Despite the president's opposition, the bill passed with vetoproof majorities.
That's the political fallout from last week's surprise Senate vote that saw 18 Republicans – including nine who reversed previous stands – vote with all Democrats to block a mandated 10.6 percent cut in payments to physicians who treat Medicare patients. On the House side, 129 Republicans broke with the White House in a June 24 vote on the bill.
If these votes hold, Congress wields more than a vetoproof, two-thirds majority in both houses. The lopsided votes are already spurring talk among Democrats of reviving previously vetoed legislation, such as a bid to expand the State Children's Health Insurance Program (SCHIP).
"This legislation sends a tremendous message to the American people, and, I hope, paves the way for bipartisan activity," said Senate majority leader Harry Reid after the July 9 vote.
On Monday, White House spokesman Tony Fratto said that Mr. Bush still plans to veto the bill, as early as Tuesday. Despite the lopsided vote – 355 to 59 in the House and 69 to 30 on a key procedural vote in the Senate – the president is committed to opposing a bill that "denies seniors healthcare choices they otherwise might have," Mr. Fratto says. In addition to physician pay cuts, the bill also proposes cuts to Medicare Advantage, a private Medicare plan that aims to create competition and, over time, lower health costs by fostering creativity. The Bush administration had delayed implementing the physician pay cut until July 15.
"There's unquestionably a bigger-picture issue here: Congress refuses to look at ways to rein in costs to the Medicare program, and any single effort to do so they choose to turn into partisan fight. The Democrats will try to paint [Republicans] as people who want to cut health costs for seniors, so people trying to reform the program are left in this very dangerous situation," Fratto says.
Some Republicans opposing the bill predicted that they could still muster enough support to prevent an override.