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How Boehner, Pelosi surprised everyone with a $200 billion deal

A few days after the chaos of a failed vote to fund the Department of Homeland Security, Speaker John Boehner asked for a meeting, alone, with House Democratic Leader Nancy Pelosi.

Compromise was on his mind.

With automatic cuts to doctors under Medicare set to take effect at the end of March, Boehner (R-Ohio) wanted to explore the possibility of a deal that would end the Sustainable Growth Rate (SGR), and with it a problem that has dogged Congress for nearly two decades.

The March 4 meeting in Pelosi’s (D-Calif.) office on the second floor of the Capitol was brief, lasting only 11 minutes.

But on the central question that has for years thwarted deal making between the parties — whether to raise taxes — Boehner got the answer he was looking for.

Democrats would not insist on tax hikes in legislation ending the Medicare formula, Pelosi told Boehner.

“That was, from our point of view, the breakthrough,” said Michael Steel, a Boehner spokesman. 

Democrats say the Medicare package is on an entirely different scale than the $4 trillion deficit-reduction package that President Obama and Democrats sought to negotiate with Republicans in 2011. Those talks broke down over the question of raising taxes, with both sides leveling bitter accusations over who was unwilling to bend.

A Democratic aide familiar with the Medicare talks called the comparison to the 2011 negotiations “not apples and oranges, but apples and baseball bats.”

Democrats view it is a victory that two-thirds of the deal is not paid for, that it includes priorities like funding for the Children’s Health Insurance Program, and that Boehner did not insist on cuts to health programs that they thought would be harmful.  

On Thursday, three weeks after the Boehner-Pelosi meeting, the Medicare deal passed the House in an overwhelming, bipartisan vote of 392-37.

The roughly $200 billion package, which is now awaiting action from the Senate, would be partially paid for, with a mix of cuts to healthcare providers and measures requiring wealthier Medicare beneficiaries to pay a higher share of premiums. 

President Obama has said he is ready to sign the bill, which would lift the threat of payment cuts to doctors who treat Medicare patients.

Senate Majority Leader Mitch McConnell (R-Ky.) expressed confidence Friday that it would clear his chamber. “We’ll move to it very quickly when we get back,” he said. 

That’s news to the ears of Boehner and Pelosi, who were already in a jovial mood when their bill passed the House.

“This is what we can accomplish when we focus on finding common ground,” Boehner said.

Pelosi said it was a “privilege” to work with Boehner and added, “I hope it will be a model of things to come.”

The foundation of the agreement, aides say, was laid long before the crucial meeting of the leaders this month.

Early last year, leaders in both parties on three key committees — Senate Finance, House Ways and Means and House Energy and Commerce — came together to propose a bill to repeal the SGR.  

Their plan replaced the cuts with modest pay increases and benchmarks to shift the payment system so that it incentivizes quality of care instead of quantity. While the framework became the core of this year’s package, it stalled in 2014 over the question of how to pay for the changes. 

Early this year, committee leaders asked House leadership for parameters they could look at on how to pay for SGR repeal. Boehner and Pelosi’s healthcare staffs began meeting in early February, laying the groundwork for the two leaders’ meeting in March. 

The Boehner-Pelosi talk ushered in the final stretch of negotiations, with members of the Energy and Commerce and Ways and Means committees brought back into the picture. Pelosi met with the ranking members of those panels, Reps. Frank Pallone (D-N.J.) and Sander Levin (D-Mich.), the same day she met with Boehner. 

Up until that point, the talks had been kept secret. Healthcare lobbyists and groups who have fought for years to end the SGR were completely in the dark.

But then came rumors, and then more credible information during the week of March 9. 

“Everybody was blindsided by it,” said Clif Porter, senior vice president of government affairs at the American Health Care Association, the skilled nursing trade group. 

That there would be a long-term fix, and that the cost would be only partially offset, “caught every credible lobbyist in DC by surprise,” he added.

The news, which also broke that week, set off a push by AHCA, and other industry groups that had long been pushing for a solution, to limit the cuts they would face under the agreement.

Rep. John Fleming (R-La.), co-chairman of the GOP Doctors Caucus, said he, too, was surprised by the news of the potential agreement. He and others met with Boehner shortly after the midterm elections and left “pessimistic” about the chances for a long-term fix because of the uncertainty about offsets. 

“We left pretty much thinking this was going to be the same old situation when we pass another six-month patch, so lo and behold I was surprised,” Fleming said.

On March 12, committee leaders briefed their members and prepared a statement that came out the next day, on a Friday afternoon, for the first time publicly confirming that there were “active discussions on a bipartisan basis.”

Some proposals proved too difficult to get into the final deal. Negotiators tried to combine Medicare Part A, which covers hospital care, with Part B, which covers doctors’ visits, to create a single deductible and a cap on out of pocket costs. 

That idea has drawn support in the past from some members of both parties as a way to streamline the system, improve care and save the government money. But when negotiators tried to help ease the changes for lower-income seniors with a lower deductible and lower out of pocket cap, it was too expensive, and the offsets would not have passed muster with either caucus, according to a Democratic aide familiar with the talks.  

Lawmakers were still making substantial progress, though threats to the deal lurked ahead. 

The Senate was not onboard. On March 19, Sen. Ron Wyden (D-Ore.) released a statement warning of an “abortion policy rider” in the package that could be objectionable.

Pelosi’s office sprung into action. The language in question, which relates to the Hyde Amendment, already bars federal funding for abortions at community health centers under an executive order, aides argued.

With those objections threatening the deal, Pelosi, working with the House Pro-Choice Caucus, by Monday night had secured additional language making clear that the Hyde language expired when the funding did. 

Republicans checked to make sure that the language was just continuing the status quo in their eyes, and agreed. 

Attempting to assure her caucus, Pelosi told Democrats Tuesday morning that she would leave Congress before ever voting to codify the Hyde Amendment, and that the bill did no such thing. 

Reps. Diana DeGette (D-Colo.) and Louise Slaughter (D-N.Y.), who co-chair the Pro-Choice Caucus, released a statement backing the bill that same day.

Asked why he chose to negotiate with Democrats, rather than moving through a bill with only Republican votes, Boehner said he seized on an opportunity to negotiate in a bipartisan way on the spending offsets.

“The door opened, and I decided to walk in it,” he said. “As simple as that.”

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Boehner still in no rush on ISIS


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TheChat: Sen. Claire McCaskill offers Speaker John Boehner a hat tip

Congratulations. It’s Friday.

▪ “We should reward Speaker Boehner for working with the Democrats and finding a compromise by saying, ‘Way to go.’” — Missouri Sen. Claire McCaskill, a Democrat, speaking of the GOP House speaker who worked across the aisle on a Medicare bill that deals with doctor payments. (link via

Interesting idea here, and one that we should hear more often. When leaders like Boehner reach across the aisle, there should be more acknowledgment of the feat in partisan, gridlocked D.C.

▪ “Just stupidity. I just assumed that he was Jewish.” — Missouri GOP chair John Hancock responding to a question about why he thought former Missouri Auditor Tom Schweich was Jewish.

Hancock is clinging to his chairmanship despite calls for him to resign in the wake of Schweich’s death. He continues to maintain his innocence when it comes to an alleged whispering campaign. “I didn’t do anything wrong,” he said.

▪ “Together we will build on our past success and not jeopardize funding because of flaws in the previous formula.” — Kansas Gov. Sam Brownback in a statement as he signed a bill that turns the school-funding formula into a system of block grants.

Lots of controversy over this new plan. Lots of angst. Lots of uncertainty, too, as lawmakers continue to offer contrasting visions of exactly what this bill means for schools.

▪ “In the coming days.” — a spokesman for Texas Sen. Ted Cruz on when the GOP presidential candidate will decide whether he’ll sign up for the Affordable Care Act.

As we reported here earlier this week in The Buzz, Cruz was planning to sign up for Obamacare, a law he’s vigorously opposed, because his wife is giving up the family’s health care plan to join her husband on the campaign trail. Now Cruz appears to be wavering on whether he’ll actually sign up for the federal health care program.

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Edward Kennedy, John Boehner, Ted Cruz: Sunday

UPDATED: The dedication of the Edward M. Kennedy Institute for the United States Senate will be a topic on the Sunday morning programs.

Kennedy’s widow, Victoria Reggie Kennedy, will be featured on NBC’s “Meet the Press,” ABC’s “This Week” and “Fox News Sunday.”

CBS’ “Face the Nation” turns to four of the late senator’s colleagues: Sen. John McCain, R-Ariz.; Sen. Barbara Mikulski, D-Md.; former Sen. Chris Dodd, D-Conn., and former Sen. Olympia Snowe, R-Maine.

The institute will be dedicated Monday in Boston. President Barack Obama, Vice President Joe Biden and Secretary of John Kerry will make remarks. So will McCain.

The Sunday morning lineup:

“Face the Nation” starts at 10:30 a.m. on WKMG-Channel 6. Other guests are Sen. Richard Burr, R-N.C.; Rep. Adam Schiff, D-Calif.; former Gov. Mike Huckabee, R-Ark.; and Capt. Chesley Sullenberger, CBS’ aviation specialist. A political panel features Dan Balz of The Washington Post, Scott Conroy of The Huffington Post, Nancy Cordes of CBS and Manu Raju of Politico.

Former Rep. Patrick J. Kennedy, D-R.I., son of Edward Kennedy, is another guest on “Meet the Press” at 9 a.m. on WESH-Channel 2. The program also features Greg Feith, former National Transportation Safety Board investigator and aviation expert. The panel will be Kathleen Parker of The Washington Post, Joe Scarborough of MSNBC’s “Morning Joe,” Neera Tanden of the Center for American Progress and Sam Stein of The Huffington Post.

Carly Fiorina, former CEO of Hewlett-Packard, and Lt. Gen. Michael Flynn (ret.) are guests on “Fox News Sunday” at 10 a.m. on WOFL-Channel 35. The panel will be George Will, Carol Lee of The Wall Street Journal, Matt Kibbe of FreedomWorks and former Sen. Evan Bayh, D-Ind.

Former Gov. Martin O’Malley, D-Md., talks to “This Week” at 11 a.m. on WFTV-Channel 9. He could challenge Hillary Clinton for the 2016 Democratic presidential nomination. The panel will be ABC’s  Matthew Dowd, Bill Kristol of The Weekly Standard, CNN’s Fareed Zakaria and former Gov. Jennifer Granholm, D-Mich.

House Speaker John Boehner, R-Ohio, and Sen. Ted Cruz, R-Texas, are guests on CNN’s “State of the Union” at 9 a.m. and noon. Dana Bash is the guest anchor.

Gov. John Kasich, R-Ohio, talks to “Sunday Morning Futures” at 10 a.m. on Fox News Channel. Other guests are Philip Jennings, general secretary of the UNI Global Union, and Zach Simms, CEO of Codeacademy. The panel will be Republican strategist Ed Rollins, journalist Judith Miller and Fred Lane, vice chairman of investment banking at Raymond James.

Ayaan Hirsi Ali of Harvard University talks to “Fareed Zakaria GPS” at 10 a.m. and 1 p.m. on CNN. She is the author of “Heretic: Why Islam Needs a Reformation Now.” Zakaria talks about his book “In Defense of a Liberal Education” with CNN’s Anderson Cooper. Other guests are Dean Ornish, MD, clinician and founder of the Preventive Medicine Research Institute; Joe Cirincione, president of the Ploughshares Fund; and Richard Haass of the Council on Foreign Relations.

Richard Behar of Forbes talks about Scientology in the media on “Reliable Sources” at 11 a.m. on CNN. Other guests are Miles O’Brien, CNN aviation analyst; Gail Saltz, psychiatrist and author;  and Thomas Erdbrink, Tehran bureau chief of The New York Times.   Frank Sesno is the guest anchor.

Juan Williams and Kathleen Parker are guests on “MediaBuzz” at 11 a.m. on Fox News Channel. The show also features Joe Concha of Mediaite, Susan Ferrechio of The Washington Examiner, radio host Richard Fowler, Sarah Lacy of PandoDaily and Nina Easton of  Fortune Magazine.




Copyright © 2015, Orlando Sentinel

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Boehner invites Benjamin Netanyahu to address Congress

Last Updated Jan 21, 2015 4:40 PM EST

House Speaker John Boehner, R-Ohio, on Wednesday invited Israeli Prime Minister Benjamin Netanyahu to address the U.S. Congress on Feb. 11 about the threat posed by Islamic extremism and the negotiations over the Iranian nuclear program.

“Prime Minister Netanyahu is a great friend of our country, and this invitation carries with it our unwavering commitment to the security and well-being of his people,” Boehner said in a statement on Wednesday. “In this time of challenge, I am asking the prime minister to address Congress on the grave threats radical Islam and Iran pose to our security and way of life. Americans and Israelis have always stood together in shared cause and common ideals, and now we must rise to the moment again.”

Netanyahu is an ardent foe of the negotiations with Iran, a longtime adversary of his country, and he’s spoken out against a deal that could leave Iran with the “break-out” capacity to convert a nuclear energy program into a nuclear weapons program.

The address would be Netanyahu’s third to a joint session of Congress. The Israeli leader previously spoke before lawmakers in 1996, during a previous stint as prime minister, and in 2011.

The invitation comes as Congress is gearing up for a debate over additional sanctions on Iran. Republican lawmakers, along with several key Democrats, hope that additional sanctions could apply pressure to Iran in the nuclear negotiations with the U.S. and its European partners. But the administration has warned that any new punitive action against Iran could end up jeopardizing the prospect of a deal.

As he has before, President Obama warned lawmakers during his State of the Union address on Tuesday to hold off on imposing any new sanctions until the negotiations conclude.

“New sanctions passed by this Congress, at this moment in time, will all but guarantee that diplomacy fails, alienating America from its allies and ensuring that Iran starts up its nuclear program again,” Mr. Obama said. “It doesn’t make sense. That is why I will veto any new sanctions bill that threatens to undo this progress.”

On Wednesday, during a meeting with the House GOP conference, Boehner took square aim at the president’s objections.

“He expects us to stand idly by and do nothing while he cuts a bad deal with Iran,” Boehner told his caucus. “Two words: ‘Hell no!’ We’re going to do no such thing.”

During a news conference on Tuesday, the speaker said he did not consult with the White House before issuing the invitation — “The Congress can make its decision on its own” — but he also insisted, “I don’t believe I’m poking anyone in the eye.”

“There is a serious threat that exists in the world, and the president last night kind of papered over it,” Boehner said. “And the fact is is that there needs to be a more serious conversation in America about how serious the threat is from radical Islamic jihadists and the threat posed by Iran.”

Netanyahu has not yet responded to the speaker’s offer, but aides to Boehner say they’ve been in consultation with the prime minister’s office for several weeks and they expect the Israelis to formally accept the invitation before the end of the day.

The speech, if it goes forward, would also come just weeks before Israel’s election in mid-march. Boehner’s invitation is being interpreted by some as an attempt to aid Netanyahu’s reelection by providing him a high-profile opportunity to address Israel’s closest international ally.

Israeli newspaper Haaretz said Wednesday that Boehner’s invitation “seems to be an attempt to intervene for Netanyhau in the Israeli elections.”

Correction: An earlier version of this story incorrectly stated that Boehner invited Netanyahu to speak next week. He is invited to address Congress on Feb. 11.

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Praying pro-lifers arrested outside of John Boehner’s office

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House GOP budget offers real expanded opportunities for American families …

Middle-class families and small businesses today want their leaders in Washington focused on real solutions to create growth and new opportunities, but President Barack Obama isn’t delivering.

Instead the president is offering the same top-down policies that have failed in the past – policies like those in his budget, which includes a 65 percent increase in spending over 10 years on the backs of taxpayers, more than $2 trillion in new taxes on working families, and piling on $8.5 trillion in new debt on our kids and grandkids. 

Remarkably, President Obama calls this approach “middle-class economics” and he’s been pushing it at public campaign-style stops across the country — including Cleveland last week.

But even liberals in Washington, D.C., aren’t buying it. Not when the Tax Policy Center confirms the president’s plan will actually raise taxes on the 20 percent of Americans making between $49,086 and $85,055 per year, Obamacare is raising premiums and health care costs, and Gallup says as many as 30 million Americans remain unemployed or underemployed. Only one Democrat in the Senate was willing to stand up and vote for the president’s budget on Tuesday.

In Cleveland and across Ohio, folks know just how tough these last seven years have been. High energy prices, rising food prices, and a difficult jobs market have hurt countless families.

And the scars still run deep. Though there’s no doubt Ohio is now on the path to recovery, thanks to the leadership of statewide and local leaders, like elsewhere in America, many middle-class families now earn less than when President Obama took office. 

If we’re going to truly bring about the growth America needs, Washington can’t just slap a new slogan on the same old approach. Bold new reforms are needed to unleash the potential of the American people and expand opportunities for everyone, and the House of Representatives continues to lead the way.

Take the budget. In stark contrast to the president’s budget, which never, ever balances, House Republicans passed a pro-growth balanced budget this week. It addresses the government’s spending problem head-on, and paves the way for job creation, a simpler and fairer tax code – and it protects critical programs like Medicare and Social Security.

And Thursday, the House voted overwhelmingly to replace one of Washington’s most infamous gimmicks, Medicare’s Sustainable Growth Rate (SGR) formula, with a more stable system that rewards quality and innovation. This permanent SGR solution is a big win for the American people and represents the first real entitlement reform in decades. It will help ensure that seniors have access to their doctor, put in place a stronger Medicare program to aid every American trying to care for elderly parents, and provide hundreds and hundreds of billions of dollars of durable savings for taxpayers over the long term.

These critical Medicare reforms now move to the Senate, and I’m pleased President Obama has said he’s ready to sign our bill, as he did our bill to help prevent veteran suicides. I also hope the president will take another look at our other bipartisan House-passed bills, including jobs measures that would approve the Keystone XL pipeline, restore the 40-hour work week to help small businesses grow and hire, and expand natural gas exports.

In the House of Representatives, we’ve had a strong first 100 days of 2015, and we’re just getting started. We’ll continue to listen to the American people and do what’s right for the country, not what’s easy.  

U.S. Rep. John Boehner of Ohio is speaker of the U.S. House of Representatives.

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John Boehner blasts Obama as dithering

Homeland chief likens Quran to ‘American values’

Saudi-armed jihadists poised to attack Syria

Ivy League dean: ISIS welcome on campus

U.S. ‘ignoring intel’ on ISIS chemical attacks

CIA chief: ISIS momentum ‘has been stopped’

Obama ‘empowering the rise of jihadist forces’

Ben Carson warns Muslim alliance could ‘destroy’ U.S.

Iraqis accuse U.S. of helping ISIS

ISIS plans to blow up Big Ben, White House

ISIS executes 9 more in propaganda video

ISIS could launch major offensive into Lebanon next month

U.S. pilots’ hands tied in war against ISIS

Colonial Williamsburg website hacked by ‘ISIS’

Franklin Graham: Muslims kill Christians to copy Muhammad

ISIS video: Boy shoots Israeli ‘spy’ in head

Egypt faces ‘existential threat’ from ISIS

Boko Haram pledges allegiance to ISIS

Leaked video: U.S. ‘allies’ execute 11-year-old boy

Americans unite: ‘Send U.S. troops to fight ISIS’

Iraqis find Saudi supplies, weapons destined for ISIS

Boko Haram beheadings show ties to ISIS

Tikrit in chaos as ISIS clashes with troops

ISIS threatens to kill Twitter employees

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Middle East experts: It is a religious war

Pentagon admits no strategy to blunt ISIS expansion

ISIS following ‘end-of-days scenario’

Pentagon defends disclosure of battle plan

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Shock reaction to Obama’s ‘poverty causes terror’ meme

Pentagon tips off ISIS on plan to take back Mosul

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U.N. urged to take charge in confronting ISIS

‘Enemy of mine enemy’ in Mideast conflict

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Franklin Graham: ISIS ‘will bow’ to Jesus

Top general: ‘Islamists embedded in White House?’

ISIS beheads, pope condemns, Obama golfs

ISIS recruiting engineers, doctors, accountants, reporters

ISIS poised to attack Christian towns

Obama asks Congress for world war on JV team

Obama challenged to ‘confront and destroy’ ISIS

6 indicted in St. Louis for aiding ISIS

Expert: FBI ‘neutered’ by Muslim Brotherhood

FBI has opened ISIS cases in 49 U.S. states

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Wrong! Islamic texts don’t ban burning people

Murder of pilot sparks tough, new question

U.S. general: ISIS seeks new terror base in Libya

Persecuted Yazidis ask Israel for help

The big flip: U.S.-backed fighters switch to ISIS

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Busted! Turkey caught smuggling weapons to al-Qaida

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Muslim woman calls for torture worse than crucifixion

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John Boehner shows hes not dead yet

It wasn’t even a month ago some of John Boehner’s closest friends feared he was so weak that he might not last as speaker.

Now, after big-ticket victories this week on the budget and entitlement reform, the Ohio Republican is about to depart Washington for the two-week Easter recess with the gavel planted firmly in hand. No one’s claiming Boehner suddenly has his fractious conference under his thumb or that his current good fortune will necessarily last once Congress returns to a host of other treacherous legislative challenges this year.

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But life has clearly been breathed back into the speaker.

“He does have nine lives,” House Majority Whip Steve Scalise (R-La.) said in an interview. “But he’s somebody who has been here a long time and he’s been a fighter and that’s probably why he is where he is.”

Opponents were writing his obituary at the end of 2014, when he passed the so-called cromnibus to fund the government over the objections of some conservatives. He then lost a stunning 25 votes in his reelection to the speakership. In late February, he had to pull a bill to fund the Department of Homeland Security after conservatives resoundingly objected to it, a move that many thought was the coda to his tenure as speaker.

Over the past two weeks, though, Boehner, Majority Leader Kevin McCarthy (R-Calif.) and House Majority Whip Steve Scalise (R-La.) turned things around. They deftly navigated the gulf between defense and budget hawks to pass a 2016 spending blueprint Wednesday. Failure could have spelled the end of his speakership — and going in, Boehner had no shortage of doubters, even among his allies.

Then on Thursday, 392 lawmakers — including 212 Republicans — voted for a bipartisan fix to the system for paying doctors who treat Medicare patients. A few weeks ago, a bill that complex would’ve caused shudders in the House Republican Conference. Had past been prologue, GOP leaders might well have had to pull the bill.

“This town works like a roller coaster,” said Scalise, who’s experiencing a rebound of his own after a rough few months. “There are big highs and big lows, and that’s just the nature of governing in a tough environment.”

Even Boehner acknowledges the swing in circumstances.

“Welcome to the legislative process,” he said of his improved political standing. “You know, I’ve got a pretty sunny personality. I was born with the glass half full. Thank God I’m an optimist. If you’re not an optimist, you couldn’t do this job.”

Fortunes in Congress are fleeting, of course, and it’s unclear how long Boehner’s current run will last.

Several tough legislative tests loom. In the coming months, Congress will need to decide again whether to reauthorize the Export-Import Bank. The government will once again hit its debt limit, potentially triggering another fiscal crisis. The nation’s highway policy expires and government funding expires at the end of September.

Not to mention, the presidential election is heating up, which promises to make governing that much harder.

Boehner’s allies say he deserves credit for not allowing himself to get too high or too low.

The speaker’s job “is not easy,” said Rep. Devin Nunes (R-Calif.). “This is not just [about] listening to talk radio or going out and listening to some group on K Street that is supposedly a conservative group. This is about governing.”

“I’ve always said the speaker is a real honest guy, hard working, all of our leadership is hard working, so a lot of these folks that are the naysayers really need to step back and look at what it takes to actually get something done in this place,” Nunes added.

Part of Boehner’s recent successes can be attributed to his willingness to depart from his long-running strategies for leading the conference. He passed a budget by allowing votes on a competing spending plan, and accepting the measure with the highest vote total. As Boehner crafted the bipartisan Medicare deal with Minority Leader Nancy Pelosi (D-Calif.), he simultaneously worked to build support in and out of the Capitol.

It has helped that his deputies, McCarthy and Scalise, have found their footing. Scalise and his No. 2, North Carolina Rep. Patrick McHenry, were able to find a rhythm in their efforts to whip votes — best displayed on the budget vote Wednesday.

At least for now, there’s a plain shift in mood among even the party’s most conservative members. Rep. Curt Clawson (R-Fla.), a member of the conservative House Freedom Caucus, voted for the so-called doc-fix despite the fact that, on paper, it would increase the deficit in the near term.

“In my mind, I separate the kinds of votes we had earlier with these votes,” Clawson said in an interview. “On ideological and philosophical votes, I think compromise is tougher. On the things that we can work together on, financial matters, compromise should be more easily obtained.”

Clawson added that internal political stability is important for the future of his party.

“For me, the speaker vote is over,” Clawson said. “The good of the party is for us to show that we can govern, and importantly, to show the financial markets we can govern. And we did that. And upheaval around anything internal to the party is not good. It’s time to move forward and govern.”

Boehner’s closest loyalists are relishing it.

”People always exaggerate where they think things are,” Rep. Steve Stivers (R-Ohio) said of Boehner’s political standing. “So they exaggerated how dead he was, and maybe people will exaggerate how amazing he is now. But certainly he’s smart and knows how to get things done. He’s a survivor.”

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Either John Boehner Or Nancy Pelosi Is Very Wrong About What Their Medicare …

The new Medicare bill that the House passed on Thursday would weaken the program.

No, wait. The new Medicare bill that the House passed on Thursday would strengthen the program.

Many liberals believe the latter, while plenty of conservatives believe the former. Their shared faith in the bill — for very different reasons — helps explain why the House gave it such a huge bipartisan majority, why the Senate might pass it and why President Barack Obama has pledged to sign it.

Of course, the predictions from the right and the left can’t both be true. A bill that bolsters traditional Medicare can’t simultaneously undermine it. But years will probably pass before we find out which side has guessed wrong.

The legislation’s formal name is the Medicare Access and CHIP Reauthorization Act. Its main purpose is to replace an old, highly unpopular and pretty crude formula for limiting what Medicare pays physicians. That scheme, known as the sustainable growth rate, or SGR, became law in 1997, as part of a sweeping effort to balance the budget. Heeding protests from the health care industry, Congress has since 2003 passed a series of measures (17, to be precise) temporarily blocking the payment cuts from taking effect.

The debate over these measures has rarely been easy. If Congress wants to pay more for doctor visits, outpatient procedures and medical tests than the federal budget anticipates, then Congress has to find the money to cover those extra fees. Members of Congress predictably have different ideas on how to do that, which is why they’ve sometimes held up enactment of a new “doc fix” until the very last minute — literally hours before the cuts were scheduled to go into effect, or even slightly after. Usually Congress has ended the drama by settling on some combination of cuts to other programs, more moderate limits on physician fees, and accounting gimmicks that basically add the cost to the deficit.

For years, lawmakers and policy experts have dreamed of a more permanent solution — a replacement that would spare Congress from this debate, and the flood of lobbying it releases every time. The compromise that House Speaker John Boehner (R-Ohio) and Minority Leader Nancy Pelosi (D-Calif.) quietly put together this year would appear to do that. Instead of curtailing Medicare’s physician payments according to the SGR formula, their bill would impose a different set of limits, reducing the fees in a less severe way and with a formula that eventually takes into account measurements of quality care. The bill would offset some, though not all, of the cost by (among other things) asking the wealthiest Medicare beneficiaries to pay higher premiums and reducing payments to some other parts of the health care industry. Most of these changes would start in 2018.

According to the Congressional Budget Office, the net effect of the bill would be to increase the federal deficit by $141 billion over the next 10 years, at least relative to what it would look like if the SGR cuts took effect. That’s a lot of money and it has raised the ire of groups like the Committee for a Responsible Federal Budget, which supports replacing the SGR but only with a measure that pays for itself completely. As Loren Adler, the committee’s research director, recently told Bloomberg’s Alex Wayne, the SGR “always gets derided because it’s annoying and it’s flawed. It doesn’t work as intended, it’s a little bit silly in some ways and it’s a lobbying bonanza. That being said, it’s accomplished what was intended — it’s controlled the cost of Medicare.”

Interest groups and prominent intellectuals on both the left and right largely agree that, in an ideal world, the bill would include enough new revenue to offset the entire cost. But many (not all) have coalesced behind the Boehner-Pelosi bill anyway, in part because they have totally divergent views of how the reforms will play out — and what might happen if the bill fails.

One big lure for conservatives enthusiastic about the Boehner-Pelosi package is those higher payments from wealthier Medicare beneficiaries. The right’s long-term goal for Medicare is to privatize it — by replacing the traditional government-run program with a voucher-like system, in which everybody would get some kind of “premium support” and then choose among competing private insurance options. Conservatives who support the bill believe that requiring more seniors to pay more of their own premiums would make such a transformation more likely.

“Some conservatives say this plan increases the national debt, is too timid, and is a giveaway of key leverage to extract annual spending cuts,” Ryan Ellis, director of tax policy at Americans for Tax Reform, wrote in National Review this week. “Other conservatives (myself included) think this bill will reduce the unfunded liabilities of Medicare without raising taxes, is a good down payment on even more entitlement reforms, and is well worth supporting.”

Liberals obviously aren’t thrilled about the higher premiums for wealthy seniors, for the very same reasons that conservatives laud them — those premiums threaten to undermine support for the traditional government-run program. But many advocates and experts on the left value some of the bill’s other provisions, starting with its funding for the Children’s Health Insurance Program and other initiatives that help low-income Americans. Securing that funding will likely be difficult — and require other, potentially more serious sacrifices — if the Boehner-Pelosi package fails.

Liberals also value the bill’s provisions tying future Medicare payments to quality. The hope is that, by making it more efficient, these changes will make it easier to sustain traditional Medicare and fend off the very challenges that conservatives covet.

“The alternative — a never-ending series of short-term patches that are fully paid for — would likely result in deeper and more painful cuts to the Medicare program over time,” a group of health care experts at the left-leaning Center for American Progress wrote on Wednesday. “While we would like to see this legislation strengthened … this compromise legislation takes an important step in Medicare payment reform and ensures continued funding that improves the health and welfare of millions of children, families, and seniors.”

It’s not every day that liberals and conservatives look at the same policy proposal and imagine it playing out in such very different ways. But in an era of unprecedented polarization, maybe such disagreement is the only way that bipartisan legislation can happen.

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