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The Doc Fix Broke - Health Care Edge: Brought to you by and the AMA

The Doc Fix Broke

By Sam Baker, Sophie Novack and Clara Ritger


27 DAYS AND COUNTING: Congress has until March 31 to pass a permanent fix to the broken SGR formula that pays Medicare physicians, or else big cuts will hit providers. Unless of course they pass a temporary patch again, which policymakers may be forced to do if they can't come to an agreement on how to pay for the proposal. But the American Medical Association's conference starts today and doctors are descending on Washington in an effort to push lawmakers to get it done. House Republicans--Majority Leader Eric Cantor, Majority Whip Kevin McCarthy and Rep. Cathy McMorris Rodgers--met Tuesday with representatives of the AMA, the American College of Physicians, the American College of Medicine, the American College of Surgeons and the American Osteopathic Association, telling the industry representatives that pay-fors have put Congress in a gridlock. That same coalition plans to meet Thursday with Senate Majority Leader Harry Reid, but it's unclear he'll have any new insight to offer the group. David Hoyt, executive director of the American College of Surgeons, said Tuesday after the meeting that there's a lot of work left to get the doc fix done, but believes Congress is still committed to finding a solution.

Top Health Care News

THE DARK SIDE OF ANTIBIOTICS: Why the CDC is advising hospitals to scale back on prescriptions. (Brian Resnick, National Journal)

ARKANSAS JUST FUNDED ITS MEDICAID EXPANSION--BUT THE FIGHT ISN'T OVER: After five failed votes, the Arkansas House passed legislation to renew funding for the state's "private option" plan...until next year. (Sophie Novack, National Journal)


Budget Resources




Budget Analysis

THE OBAMACARE MONEY CONGRESS CAN'T TOUCH: The White House is planning to spend $6.4 billion by the end of next year to support Obamacare's state health insurance exchanges, and there's nothing Congress can do to stop it. Meanwhile, funding for the federal exchange largely requires approval from lawmakers who have taken a hardline against allocating money for the ACA. (Sophie Novack, National Journal)


THE OBAMACARE FUNDING FARCE: President Obama is asking Congress for more money to fund Obamacare's implementation, but Republicans are unlikely to give it to him. The law will continue to be implemented with or without Congress's help, as it contains ways to fund itself anyway. But the two parties continue to standoff over Obamacare funding, and it has real consequences. (Sam Baker, National Journal)

HOSPITALS PUSH TO STOP BUDGET CUTS TO HEALTH CARE PROVIDERS: The Obama administration proposed cutting $2 billion but an industry lobbying group says they're generating enough savings that they don't deserve more cuts. (Clara Ritger, National Journal)

OBAMA BUDGET BOOSTS FUNDS TO FIGHT 'NIGHTMARE BACTERIA': Inappropriate use of antibiotics endangers patients' health. (Liz Szabo, USA Today)


Health Care Edge is one of my top resources."

Meghan, Associate Specialist

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INSURERS' OBAMACARE LOSSES MAY REACH $5.5 BILLION IN 2015: But it's not so bad for the companies after all, as Obama's proposed budget contains the money as a fund to draw from if insurance company losses are greater than expected, based on the health of the population enrolling in plans. (Alex Wayne, Bloomberg News)


LOS ANGELES APPROVES SWEEPING NEW E-CIGARETTE REGULATIONS: Lawmakers outlawed vaping in most work sites and many public places, including parks and certain beaches. (David Zahniser, Los Angeles Times)

E-CIGARETTES, BY OTHER NAMES, LURE YOUNG AND WORRY EXPERTS: Public health officials are already struggling to measure the spread of e-cigarettes, and worry they're not measuring the spread of the devices given the new products and new names infiltrating the market. (Matt Richtel, New York Times)


60K HIV PATIENTS LEFT UNINSURED IN STATES CHOOSING NOT TO EXPAND MEDICAID: A study published in Health Affairs found that nearly 115,000 people with HIV/AIDS would gain coverage if all states opted into Medicaid expansion under the ACA. (Jenny Gold, Kaiser Health News)

CHRIS CHRISTIE: 'FOLKS ARE BETTER OFF' WITH OBAMACARE'S MEDICAID EXPANSION: Although the New Jersey governor does not support Obamacare, he did expand Medicaid in his state. (Sahil Kapur, Talking Points Memo)

MISSOURI HAS A BACKLOG OF MEDICAID APPLICATIONS: Some 22,000 parents and children are waiting to find out if they qualify for the health program. (Associated Press)

VIRGINIA HOUSE REPUBLICANS UP POLITICAL ANTE, CALL FOR SPECIAL SESSION ON MEDICAID EXPANSION: The surprise move is meant to extricate the issue from the state budget, avert a potential government shutdown and put Democrats on the defensive. (Laura Vozzella, Washington Post)

FOR SOME NEW MEDICAID CLIENTS, DELAYS GETTING CARE AND PRESCRIPTIONS: Connecticut health officials say problems with Medicaid are the most common reason people call for help. (Arielle Levin Becker, The CT Mirror)


A RADICAL RETHINKING OF PRIMARY CARE THAT COULD MAKE EVERYONE HEALTHIER: "The clinic practice is run by Iora Health, a Cambridge-based start-up that believes it can make patients healthier at a lower cost by increasing access to basic health care services and by thinking more broadly about what basic services should be. 'We often say, our job is not to improve people's health,' says founder and CEO Dr. Rushika Fernandopulle. 'Our job is to improve people's life. And that will improve people's health.'" (Sophie Quinton, National Journal)

THE DOCTOR VISIT OF THE FUTURE MAY BE A PHONE CALL: More states are requiring insurers to cover health visits by phone or internet. (Jonnelle Marte, MarketWatch)


50TH VOTE'S THE CHARM FOR OBAMACARE REPEAL? The House is scheduled to vote Wednesday on a bill to effectively delay the mandate for a year, by reducing the 2014 penalty from $95 to $0. (Sahil Kapur, Talking Points Memo)

MILITARY GROUPS BRACE FOR BATTLE AGAINST HIGHER HEALTH CARE COSTS: Lawmakers are expected to stall on benefits cuts in the midterm election year. (Stacy Kaper, National Journal)


TOO MUCH ANIMAL-BASED PROTEINS COULD LEAD TO EARLY DEATH, STUDY SAYS: Middle aged adults who ate a diet rich in animal-based proteins were more likely to die of cancer, diabetes. (Brady Dennis, Washington Post)

LAST-DITCH CHEMO MAY MEAN DEATH IN THE ICU, STUDY SAYS: Although most cancer patients say they'd like to die peacefully and painlessly at home, the study suggests that taking an attitude of fighting up to the last minute could mean an uncomfortable or even miserable death. (Maggie Fox, NBC News)

Happening Today

POLITICO BREAKFAST BRIEFING ON HEALTH CARE: A look at the current policy landscape with Reps Becerra and Ellmers. Doors open at 7:30 a.m. at the Ritz Carlton Hotel in D.C.

AMERICA'S HEALTH INSURANCE PLANS ANNUAL CONFERENCE: AHIP's National Health Policy Conference will be held Wednesday and Thursday at the Ritz Carlton Hotel. Events surrounding the Affordable Care Act's implementation begin at 8:30 a.m.

AMERICAN MEDICAL ASSOCIATION NATIONAL ADVOCACY CONFERENCE: Doctors will gather in D.C. to push a permanent fix to the flawed Medicare physician payment formula known as the "doc fix" or SGR.

HOUSE TO VOTE FOR ONE-YEAR INDIVIDUAL MANDATE DELAY: Rep. Lynn Jenkins, R-Kan., introduced the bill Friday.



Health Care Edge is one of my top resources."

Meghan, Associate Specialist

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