The Medicare savings provisions in the House and Senate health bills are very different from the poorly designed SGR cut [i.e. ''doc fix"]. Instead, they are similar in both size and design to the past Medicare cuts that Congress has allowed to take effect.
Unions argued against the tax on the grounds that their members had foregone wage hikes in order to obtain expensive health insurance. Providing a short-term reprieve for health plans obtained through collective bargaining was a reasonable way to keep most of the bite of the tax in place while accommodating those concerns. Alternatively, Democrats could have stiffed the unions if a few Republicans stepped forward to support the bill in exchange for tough cost control measures that Obama clearly wanted. But none would do that. It's impossible to pass health care reform without the support of labor unions or any Republican member of Congress