On Thursday, the House touched the third rail. Lawmakers didn't punt. They didn't kick the can down the road. And they were bigger than the clichés that have come to describe the predictable patterns of Congress.
In a bipartisan vote, 392-37, House lawmakers passed a bill to end the "sustainable growth rate" used to calculate doctor's payments for Medicare. After extending the program 17 times with only partial offsets, the House sent a bill to the Senate that would eliminate the need for patches and would pay for at least some of it by changing how much wealthy seniors pay for their Medicare prescriptions and doctors visits, and by instituting a $147 deductible for supplemental Medicare coverage (Medigap). While many conservatives inside and outside the House were eager to point out that the deal between Democrats and Republicans would raise the deficit over the next 10 years — and would institute new rules for doctors , and included seemingly unrelated provisions — leadership on both sides of aisle pointed to the long-term savings. "Normally, we're here to admit that we've kicked the can down the road," Speaker John A. Boehner said on the floor Thursday. "Today, because of what we're doing here, we will save money 20, 30, 40 years down the road."
"Don't look now, but we're actually governing," Renee Ellmers, R-N.C., said on the floor Thursday.
Majority Leader Kevin McCarthy, R-Calif., noted that every year he'd been in Congress, there was always another "doc fix."
"This is a big moment for Congress," McCarthy said, "and I think we should all realize it."
Minority Leader Nancy Pelosi, D-Calif., also had warm words for lawmakers, staff and the legislative branch. "We are legislating," she said. "We are working together to get the job done for the American people."
Pelosi called the bill a "historic bipartisan package," and she noted the deal came together over the past few months with Boehner and his staff. Part of the deal would extend the Children's Health Insurance Program for two years. Senate Democrats have been expressing frustration that CHIP isn't extended for four years, and, on Wednesday, White House Press Secretary Josh Earnest called on Senate Majority Leader Mitch McConnell, R-Ky., to allow amendments to the legislation when it gets to the Senate.
But that could be a tricky prospect for the Senate, which needs to advance a measure before March 31 to avoid a 21 percent reduction in Medicare payments to doctors. Opening the bill up on the Senate side would also give conservatives an opportunity to address the dearth of offsets in the first 10 years. But breaking up the bill for extensive overhaul is also a dangerous proposition. The idea from the House has always been to jam the Senate by not giving them enough time for a prolonged debate, something both Boehner and Pelosi have told their members.
But, as Pelosi said Thursday, the legislation is "transformative," and the Senate could send over another short-term extension just to avoid the March 31 deadline. It's unclear whether the House would support such a move. They leave for a two week recess on Thursday.
Either way, the House made a strong expression of support for the bill, and leaders signaled that this was a bill they would do everything in their power to make sure was signed into law.
After Pelosi finished her floor speech, Pennsylvania Republican Joe Pitts, who was managing time on the GOP side, took a few seconds to thank her for her work on the SGR issue, and wish the 75-year-old minority leader a happy birthday.
From across the chamber, seemingly referring to the bill, Pelosi shouted over to Pitts.
"Best present of all," she said.
Related: Why the 'Doc Fix' Deal Has Senate in Something of a Fix Quiet Win for Boehner? Bending the Entitlement Curve Permanent 'Doc Fix' Could Shift K Street Business The 114th: CQ Roll Call's Guide to the New Congress Get breaking news alerts and more from Roll Call in your inbox or on your iPhone.