Medicare Physician Payment Reform On House Floor – AMA Calls GOP Hypocrisy

Today, the House is debating the Medicare Physician Payment Reform Act (HR 3961), companion legislation to the Affordable Health Care for America Act which will permanently reform the way Medicare pays physicians. The bill prevents a 21% cut in Medicare physician payment rates scheduled for January 2010 instead of temporarily overriding the cut as Congress has done six times before. The bill replaces the broken Sustainable Growth Rate (SGR) formula, correcting a decade of Republican mismanagement of the Medicare program with a permanent, sustainable solution–guaranteeing that Medicare beneficiaries will continue to enjoy the excellent access to care that they do today and ends a budget gimmick that artificially reduces the deficit by assuming physician payments will be cut by 40% over the next several years even though Congress has consistently intervened to prevent those cuts from occurring. This chart shows how previous bills by Republican controlled Congress’ created short-term, temporary “fixes” that were “paid for” by digging ever deeper holes that they knew would never occur:

Previous bills by Republican controlled Congress

The White House released a Statement of Administration Policy in strong support of the bill yesterday saying it “is an important step forward in comprehensively reforming the way Medicare pays physicians to provide the very best care to the Nation's Medicare beneficiaries and the Administration urges the Congress to pass this legislation.”

The bill is supported by a wide range of organizations representing patients, doctors and other providers, including the American Medical Association, AARP, the Military Officers Association of America, the American Academy of Family Physicians, the American College of Physicians, the American College of Surgeons, the Center for Medicare Advocacy, the Medicare Rights Center, and the National Committee to Preserve Social Security and Medicare.

Despite the wide support, many Republicans have said that they will vote against the bill. Today, the American Medical Association (AMA) sent a letter to Ways and Means Ranking Member Dave Camp (R-MI) — a staunch opponent of the bill. In the letter, the AMA points out that legislation on the House floor today “is the same policy supported by every Republican on the Ways and Means Committee,” including Camp, who voted in favor earlier this year. From the letter:

We are disappointed, however, that you and your colleagues do not support the bill. As you know, the SGR was put into place by the Balanced Budget Act of 1997, which originated in your committee. At that time, the AMA wrote numerous letters to Speaker Gingrich and your committee leadership warning that limiting growth in physician services to GDP would inevitably lead to sharp cuts in physician reimbursement and a crisis in access to care for our nation's seniors.

This should not be a partisan issue. Both sides of the aisle have professed a desire to permanently address this issue. The opportunity to advance permanent reform through passage of H.R. 3961 cannot be missed. We urge all members to vote for H.R. 3961.

In addition, Republicans have been calling this bill a “budget gimmick.” The AMA says no:

As for the implication that the recent action by the Administration to remove drugs from the SGR are 'budget gimmicks to hide the true deficit impact,' we are reminded of a letter you signed on May 21, 2004, to the Bush administration calling the policy of including drugs in the formula 'our greatest concern' regarding the magnitude of the SGR problem. That letter was also signed by other members of your committee. On June 16, 2004, Representative Cantor sent a similar letter with Representative Pryce urging that CMS 'remove prescription drug expenditures from the Sustainable Growth Rate (SGR) determination.'

Watch the debate live on CSPAN»

Learn more about the Medicare Physician Payment Reform Act»

UPDATE: The House passed the Medicare Physician Payment Reform Act by a vote of 243-183. Speaker Pelosi on passage:

Strengthening Medicare for generations to come is essential to our efforts to reforming health care for all Americans. This legislation will permanently improve the way Medicare pays physicians and in doing so, guarantee that America's seniors will continue to have access to excellent care through Medicare.

This legislation is a top priority for seniors and was endorsed by the AARP and the American Medical Association because it protects seniors' access to their doctor, promotes primary care, and offers incentives for doctors to provide patients with higher quality and more efficient care. Today's vote by the House keeps our promise to strengthen Medicare, never weaken it.

As this legislation heads to the Senate, the statutory 'pay as you go' budget bill will be added to ensure that we put our nation back on a path of fiscal responsibility and begin to bring down the deep deficits that face our nation.