On March 22, 2013, the Senate cast a duo of votes on the wage index issue during a series of votes on the budget resolution. The two votes related to Section 3141 of the Affordable Care Act (ACA), which critics have dubbed “Bay State boondoggle.” This provision adjusted the calculation of the Medicare hospital wage index, increasing payments to hospitals in a few states by reducing payments to the majority of states (resulting in big financial gains for Massachusetts).

First, Senators Tom Coburn (R-OK), Claire McCaskill (D-MO), and Tammy Baldwin (D-WI) sponsored an amendment version of their legislation, S. 183. The “Coburn amendment,” which seeks to reverse Section 3141, passed by a strong bipartisan margin of 68 to 31. Because the budget resolution is non-binding, the passage of this amendment does not have the force of law; however, it was viewed as a test of how much support existed for eliminating what Senator Coburn called a “payment earmark.”

Second, Senators Robert Menendez (D-NJ), Lautenberg (D-NJ), Warren (D-MA), and Cowan (D-MA)—all of whom voted against the Coburn amendment—sponsored a corresponding amendment calling for a comprehensive approach for wage index reform, rather than singling out one provision of the ACA. This amendment failed by a vote of 49-50.

Accordingly, the bipartisan vote to eliminate the “Bay State boondoggle” does not seem to indicate enthusiasm to take a widespread look at the entire wage index policy.