John Williams, an attorney who specializes in government and public policy for Hall, Render, Killian, Heath & Lyman, an Indianapolis-based healthcare law firm, wrote in an e-mail exchange, "I don't think there is any way the House passes a stand-alone bill under regular order that isn't completely paid for because rank and file Republicans won't vote for it."
He added that anything adopted at the mark-up, such as funding cuts to the Affordable Care Act, will be "complete non-starters in the Senate."
While there is some expectation that an SGR repeal-and-replace bill will likely hit the House floor, the outlook is less optimistic on the Senate side.
Despite several months of hearings and stakeholder input, Senate Finance Committee, has yet to produce any SGR legislation. While there is some thought that Sen. Max Baucus (D-MT), the Finance Committee chair, is preoccupied with getting tax reform passed, the lack of action probably reflects the reality of identifying offsets (pay for) that are acceptable to Congress and the White House.
"A long-term [SGR] fix will need a significant [dollar] offset," says Christopher Condeluci, an attorney with law firm Venable in Washington, D.C. and a former tax counsel for the Senate Finance Committee. In May the Congressional Budget Office scored the 10-year repeal cost at $138 billion, which is almost a bargain basement rate compared to the $234 billion price tag for its 2012 score.