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Last month I passed along the news that, in a break with recent tradition, Congress might actually do something useful and pass a permanent fix to Medicare’s Sustainable Growth Rate, a well-meaning policy that turned out not to be sustainable at all when its formula started calling for actual cuts in payments to doctors. Every year Congress addresses this by passing a one-year “doc fix,” but recently a bipartisan effort finally came together to pass a permanent modification. Hooray!

But now it turns out that congressional Republicans enjoy the tradition of dysfunctional government too much to give it up. Sahil Kapur reports that hostage-taking is back:

House Republicans expect to vote this Friday on legislation that would risk steep, destabilizing Medicare cuts at the end of the month unless Democrats agree to a five-year delay of Obamacare’s individual mandate.

It mirrors some of the brinkmanship in the government shutdown fight last fall in that the GOP is using a must-pass bill as a vehicle to chop the Affordable Care Act. Democratic leaders have repeatedly rejected proposals to tinker with the mandate to buy insurance and have warned Republicans not to tie a physician payment fix to their partisan quest to unravel Obamacare.

Insurance companies oppose this. Doctors oppose this. The CBO says it would be a disaster. It obviously has no chance of passing. But it looks like Republicans are going right up to the brink once again. I guess that once you’ve tasted the thrill of threatening to shoot a hostage, nothing else quite compares.

Besides, there’s a midterm election coming up. Have I mentioned that before?

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