Throughout the entirety of the current Congress, Republicans have adhered to a strict obstruction whenever possible regimen in the hopes of thwarting any and all progressive change. While by and large the media have given the GOP a pass on the subject (save for a few stories here and there from McClatchy or The Washington Post), it was bound to be the case that the GOP's tactics would come back to bite them at some point.  

According to Congressional Quarterly (subscription required), for instance, the American Medical Association, a group that has overwhelmingly backed Republicans in the past (giving at least 61 percent of their contributions to GOP candidates since 1990), is now not only withdrawing support from Republicans but is going so far as running ads against endangered GOP Senators up for reelection this fall on the topic of harsh cuts in Medicare payments to doctors supported on Capitol Hill by those members.

The Senate vote has made for an easy talking point for Democrats and doctors. In the AMA ads, a narrator charges: "A group of U.S. senators voted to protect the powerful insurance companies at the expense of Medicare patients' access to doctors."

The ads name GOP Sens. John Cornyn and Kay Bailey Hutchison of Texas; John E. Sununu of New Hampshire; John Barrasso and Michael B. Enzi of Wyoming; Bob Corker and Lamar Alexander of Tennessee; Roger Wicker and Thad Cochran of Mississippi; and Arlen Specter of Pennsylvania.

Alexander, Cornyn, Sununu, Barrasso, Enzi, Cochran and Wicker all face elections this year. Sununu and Wicker are seen by Democrats as particularly vulnerable.

An AMA spokeswoman would not say what the association is paying to run the ads, but called the buy "significant."

Per the CQ article, this fracas is making particular waves in Texas, where the local AMA actually withdrew its support for GOP incumbent John Cornyn, and Mississippi, where Democrat Ronnie Musgrove is talking about the issue at all of his events. (Note that both races are being targeted in the MyDD Road to 60 effort). For those interested, a version of the ads the AMA is running in these races is available online here.

For those not entirely familiar with the GOP obstruction on this front, here's The New York Times' Robert Pear:

Doctors face a 10 percent cut in Medicare payments next week, following the Senate's failure on Thursday to take up legislation that would have averted the cuts.

Republican senators blocked efforts by Democrats to call up the bill, which was approved Tuesday in the House by an overwhelming bipartisan vote of 355 to 59.

In the Senate, supporters fell two votes short of the 60 needed to close debate. The vote was 58 to 40.

Senator Charles E. Schumer, Democrat of New York, said, "We have to pass this bill to avoid catastrophic cuts to doctors."

Dr. Nancy H. Nielsen, president of the American Medical Association, said the cuts would force many doctors to "limit the number of new Medicare patients they treat."

All in all, there is a simple narrative, one that we have heard over and over again in recent years (and indeed for the past several decades, at least since the New Deal): When push comes to shove and the Republicans have had to choose between the people and the special interests that fund GOP efforts, Republicans will almost invariably choose the latter.

By the way, nice work John McCain for not even bothering to show up for the vote -- particularly given that your support for the measure would have meant that the bill would have passed (Senate Majority Leader Harry Reid switched his vote to "no" for parliamentary reasons so that he could bring the measure up again in the future, so the bill actually had the support of 59 Senators).