Similar to the alternative minimum tax, Congress usually passes an annual "doc fix" to the current formula -- established by the Balanced Budget Act of 1997 -- in order to prevent potential Medicare payment cuts to physicians. A yearly fix has been more palatable to both parties since the cost is significantly lower than a permanent resolution.

"The physician fix was left out of the Finance Committee, I suspect, not because my colleagues do not agree it is a fundamental part of health care reform but because it would have cost money my colleagues did not want to account for in the bill," argued George Voinovich (R-OH) following yesterday's vote, referring to the America's Healthy Future Act. "If the Finance Committee would have included the fix in their bill, the $81 billion surplus they say the bill will create would have quickly turned into a deficit."

After the vote on S. 1776, Senate Majority Leader Harry Reid (D-NV) filed a motion to end debate on whether to proceed to the Unemployment Compensation Extension Act (H.R. 3548), legislation that has repeatedly stalled in the chamber. As passed by the House, H.R. 3548 would extend unemployment benefits to states where the unemployment rate is 8.5 percent or higher. However, Reid is expected to offer an alternative proposal to the House-passed bill that would provide an extension to all 50 states by up to 14 weeks, and up to 20 weeks for states with unemployment levels exceeding 8.5 percent. The cost of both proposals would be offset by extending the roughly $14 annual unemployment tax paid by employers for each employee.

The vote on whether to proceed to the unemployment extension bill is scheduled to occur tomorrow.