This vote was on killing an amendment by Chuck Grassley, R-Iowa, that would have extended Medicare reimbursement rates for doctors and paid for the Medicare-related portions of the bill by shifting money out of the Medicare Improvement Fund (MIF). The amendment was offered to a bill that would extend for varying lengths of time, mostly around a year, several programs that would otherwise have expired within a month. These include unemployment benefits, heath insurance subsidies, small business loans and flood insurance. The underlying bill also would shift money out of the MIF, but only for four months of the bill’s length; the rest would be deficit spending.

Max Baucus, D-Mont., said the amendment should be defeated because it takes money out of the MIF. Baucus said lawmakers plan to use the money in that fund to help defray some of the costs of a massive health insurance overhaul bill that is making its way through Congress.

“The Medicare Improvement Fund is very—it is almost essential so that we have funds to pay for the underlying health care bill. It is very important that the underlying health care bill be deficit neutral. This Medicare Improvement Fund can help very much toward assuring us that the underlying bill, the health reform bill, is in fact deficit neutral,” Baucus said.

Grassley suggested Baucus was being hypocritical, considering that the underlying bill already takes money out of the MIF to offset its costs – just not as much as it would with Grassley’s amendment.

“My friend from Montana said that is not the place to take the money from, but his substitute amendment takes money from the very same fund. I take a little bit more, yes, but I don’t think a few billion in funding needed here will make much of a difference when it comes to the $2.5 trillion cost of health care reform, as was suggested earlier. So I don’t see that as a valid argument for not paying for these Medicare provisions,” Grassley said.

Baucus then made a motion to kill Grassley’s amendment.

By a vote of 54-45, the motion to kill the amendment was adopted. All but five Democrats present voted to kill the amendment. Every Republican present voted against killing the amendment. The end result is that the Senate voted to kill an amendment that would have paid for the bill’s Medicare spending by shifting money out of the Medicare Improvement Fund.