Even though President Obama will sign the health care bill into law today, the Senate is now taking up House-approved changes in the comprehensive measure that could keep the debate rolling for months. Iowa Senator Chuck Grassley, a Republican, is working to restore what he calls “rural health care equity” to the massive undertaking.

Grassley says, “The issue is how Medicare is going to calculate payments to physicians and unfairly penalize rural doctors, making it harder for rural Medicare beneficiaries to find a doctor.” Grassley had an amendment in the original bill which he says would have improved the way the government determines what doctors in rural states are paid for treating Medicare patients.

Now, he says, the amendment has been “undermined” to offer advantages to five so-called “frontier” states. “These five states will get extra help, above and beyond what I had previously gotten for all rural states,” Grassley says. “Their extra help then will hurt other rural states, including Iowa, because it now will be more difficult to get an even-handed change in the formula for everyone.”

The states that are being singled out are: Montana, North Dakota, South Dakota, Wyoming and Utah. Grassley says the frontier state exceptions were the result of “special deals written behind closed doors in (Senate Majority Leader Harry) Reid’s office” last year. Iowa Congressman Steve King says he’s introducing a bill to repeal what he calls “Obamacare,” but Grassley says he’s not ready to make that leap yet.

“Obviously, nothing’s going to happen until the next election and in regard to a repeal, I’m taking a step at a time,” Grassley says. “I’m going to wait until we’re done here in the United States Senate before I make any determination for the future.”

King, in a news release, says: “The American people must take their country back by methodically eliminating every vestige of creeping socialism, including socialized medicine. The Pelosi Democrats will pay a price for their overreach. The fight is far from over.”