ABC News' Z. Byron Wolf reports:
There are going to be a whole lot of angry Medicare doctors banging on lawmakers' doors tomorrow.
Senate Democrats just failed for the second time this week to get the 60 votes they need for a host of expiring social programs and corporate tax credits.
Sen. Joe Lieberman, I-Conn., and Sen. Ben Nelson, D-Neb, voted with Republicans.
The expiring provisions include extending emergency unemployment benefits for the long unemployed and averting a 21 percent pay cut for Medicare doctors. The latter is an ongoing issue in Washington, where deficit reduction laws known as the Sustainable Growth Rate mandate cuts to keep Medicare solvent but lawmakers periodically pass legislation to ignore them. The cuts have piled up over the years.
CMS, the government agency that administers Medicare, had directed contractors not to submit payments during the past two weeks since the previous extension expired.
But the 21 percent pay cut will take effect Friday.
"There is going to be havoc in America starting tomorrow," said Senate Majority Leader Harry Reid, D-Nev., on the Senate floor.
Senate Minority Leader Mitch McConnell, R-Ky., disagreed.
"Americans want us to show we are serious about actually lowering the debt," he said.
Republicans proposed offsetting the cost of the expiring provisions with cuts to the stimulus bill.
The unemployment, Medicare and COBRA subsidies lapsed two weeks ago. But Democrats have fought Republicans and some in their own party concerned with skyrocketing deficits and the $13 trillion national debt.
Senate Democrats scaled back a version of the extenders bill they received from the House to about $80 billion of deficit spending on Wednesday. That version got only 45 yes votes, far short of the 60 needed to overcome a filibutster. They scaled back even further in recent days, shortening the doc fix and slimming the unemployment benefits so the bill would have added about $50 billion to the debt. That version failed tonight, although it gained 11 yes votes and came closer to 60.