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			 Final action came as the Senate voted 92-8 to approve the so-called 
			"doc fix". The House of Representatives had acted over two weeks 
			ago. The bill now goes to President Barack Obama, and he is expected 
			to sign it into law. 
			 
			The measure, drafted last month by Republican House Speaker John 
			Boehner and Democratic Minority Leader Nancy Pelosi, appeared to be 
			the first major legislative accomplishment of the 2015-2016 
			Congress, suggesting some progress toward easing years of gridlock 
			on Capitol Hill. 
			 
			In a statement, Obama applauded lawmakers for passing the bill, 
			saying it would strengthen the U.S. healthcare system. "I will be 
			proud to sign it into law," he said. 
			 
			The bill would replace a 1990s formula that linked Medicare doctor 
			pay to economic growth, with a new formula more focused on quality 
			of care. It also would require means-testing of Medicare 
			beneficiaries so higher income people pay higher premiums. 
			  
			One of the government's largest social safety net programs, Medicare 
			is health insurance that serves 54 million elderly and disabled 
			people. 
			 
			The old formula for paying Medicare doctors has been a problem for 
			years as health care costs outpaced economic growth. Congress had 
			repeatedly addressed the problem with a long series of temporary 
			"doc fix" patches. The new formula is intended to be a lasting 
			change. 
			 
			The federal government warned Congress last week that it must act 
			before April 15 or thousands of Medicare doctors nationwide would 
			face a 21 percent pay cut under the old reimbursement formula. 
			 
			The deadline for action actually had been April 1, but because 
			Medicare doctors' claims generally take at least 14 days to be paid 
			by the government, the pay cuts were not expected to be implemented 
			before April 15 - Wednesday. 
			 
			The measure passed the House overwhelmingly in March but because it 
			expands the federal deficit, it was greeted skeptically by deficit 
			hawks in the Senate. 
			 
			They labeled the bill irresponsible because it would add an 
			estimated $141 billion to the U.S. debt over the next 10 years, 
			according to the Congressional Budget Office (CBO). 
			
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			But an amendment sponsored by Senator Mike Lee requiring Congress to 
			find ways to pay for the "doc fix" by the end of this year, failed 
			to pass Tuesday on a vote of 42-58. 
			The legislation includes a two-year extension of the Children's 
			Health Insurance Program (CHIP) for low-income children and a 
			two-year extension of funding for community health centers. 
			 
			Both were high priorities for Democrats, and they tried to extend 
			them to four years, but their amendments failed. They also tried to 
			take out some anti-abortion language, but the amendments failed. 
			 
			Healthcare groups were leaning hard on the Senate to approve the 
			measure, and Senate Majority Leader Mitch McConnell argued Tuesday 
			for approval, noting it included more means testing of Medicare 
			beneficiaries. 
			 
			Boehner also urged the Senate to pass the House bill on Tuesday, 
			saying the House had no intention of acting again on the measure if 
			the Senate amended it. 
			 
			(Additional reporting by Lisa Lambert; Editing by Kevin Drawbaugh, 
			Sandra Maler, Christian Plumb, Ken Wills and Clarence Fernandez) 
			[© 2015 Thomson Reuters. All rights 
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