Doctors Are Tired of Being ‘Fixed’ by Congress

Congress got close to replacing Medicare’s payment formula but fell back on yet another short-term patch.

MIAMI, FL - FEBRUARY 21: Dr. Martha Perez examines Maria Lebron in a room at the Community Health of South Florida, Doris Ison Health Center on February 21, 2013 in Miami, Florida. Florida Gov. Rick Scott reversed himself on February 20, and now is callling for an expansion of Medicaid to Florida residents under the federal Affordable Care Act. (Photo by Joe Raedle/Getty Images)
National Journal
Clara Ritger
See more stories about...
Clara Ritger
March 31, 2014, 8:21 a.m.

Doc­tors’ groups are not happy about Cap­it­ol Hill law­makers’ in­ab­il­ity to reach agree­ment on Medi­care pay­ments.

The Sen­ate voted 64-35 to pass an­oth­er short-term “doc fix” on Monday, delay­ing a 24 per­cent cut in Medi­care’s pay­ments to doc­tors. The one-year patch squeaked through the House last week in a voice vote that many mem­bers didn’t even know was hap­pen­ing.

And doc­tors’ lob­by­ing as­so­ci­ations aren’t happy about it. They had high hopes for a solu­tion that would per­man­ently re­place Medi­care’s pay­ment sys­tem.

“The phys­i­cian com­munity made some tough choices and com­prom­ises,” a rep­res­ent­at­ive at one phys­i­cians’ or­gan­iz­a­tion said. “And we didn’t really see the same ef­fort put for­ward on the pay-fors. Frankly, I think that there was a re­luct­ance on both sides of the aisle — on both sides of the Cap­it­ol — to make pro­vider cuts, re­luct­ance to make those choices pri­or to the elec­tion.”

Since 2003, Con­gress has passed 16 “doc fixes” to stop auto­mat­ic cuts put in place by the Sus­tain­able Growth Rate for­mula used to de­term­ine Medi­care phys­i­cians’ pay.

The Sen­ate’s vote is widely viewed among the doc­tor com­munity as the dis­ap­point­ing con­clu­sion of a long, bi­par­tis­an, bicam­er­al ef­fort to come to agree­ment on a long-term re­peal and re­place­ment of that for­mula. Law­makers and in­terest groups reached an agree­ment on the sub­stance of a new pay­ment for­mula, but they couldn’t agree on how to off­set the bill’s roughly $140 bil­lion price tag.

“Too many in Con­gress lacked the cour­age and where­with­al to per­man­ently fix Medi­care to im­prove care for pa­tients and provide great­er cer­tainty for phys­i­cian prac­tices,” Ar­d­is Dee Hov­en, pres­id­ent of the Amer­ic­an Med­ic­al As­so­ci­ation, said in an email. “Con­gres­sion­al lead­er­ship had to re­sort to trick­ery to pass an SGR patch that was op­posed by phys­i­cians.”

The AMA, along with more than 80 oth­er doc­tors’ groups, sent a let­ter to House lead­er­ship con­demning the short-term fix.

What a short-term patch means for the le­gis­la­tion that would per­man­ently re­peal and re­place the SGR for­mula is un­clear: Mem­bers of Con­gress could sit back down to the ne­go­ti­at­ing table in the fall, after the midterm elec­tions, when they are fa­cing no guil­lot­ine if they make un­pop­u­lar cuts to pay for the bill.

This story was up­dated at 7 p.m. East­ern to in­clude the Sen­ate vote count.

What We're Following See More »
TAKING A LONG VIEW TO SOUTHERN STATES
In Dropout Speech, Santorum Endorses Rubio
3 days ago
THE DETAILS

As expected after earlier reports on Wednesday, Rick Santorum ended his presidential bid. But less expected: he threw his support to Marco Rubio. After noting he spoke with Rubio the day before for an hour, he said, “Someone who has a real understanding of the threat of ISIS, real understanding of the threat of fundamentalist Islam, and has experience, one of the things I wanted was someone who has experience in this area, and that’s why we decided to support Marco Rubio.” It doesn’t figure to help Rubio much in New Hampshire, but the Santorum nod could pay dividends down the road in southern states.

Source:
‘PITTING PEOPLE AGAINST EACH OTHER’
Rubio, Trump Question Obama’s Mosque Visit
3 days ago
WHY WE CARE

President Obama’s decision to visit a mosque in Baltimore today was never going to be completely uncontroversial. And Donald Trump and Marco Rubio proved it. “Maybe he feels comfortable there,” Trump told interviewer Greta van Susteren on Fox News. “There are a lot of places he can go, and he chose a mosque.” And in New Hampshire, Rubio said of Obama, “Always pitting people against each other. Always. Look at today – he gave a speech at a mosque. Oh, you know, basically implying that America is discriminating against Muslims.”

Source:
THE TIME IS NOW, TED
Cruz Must Max Out on Evangelical Support through Early March
3 days ago
WHY WE CARE

For Ted Cruz, a strong showing in New Hampshire would be nice, but not necessary. That’s because evangelical voters only make up 21% of the Granite State’s population. “But from the February 20 South Carolina primary through March 15, there are nine states (South Carolina, Alabama, Arkansas, Georgia, Oklahoma, Tennessee, Kentucky, Mississippi, and North Carolina) with an estimated white-Evangelical percentage of the GOP electorate over 60 percent, and another four (Texas, Kansas, Louisiana, and Missouri) that come in over 50 percent.” But after that, he better be in the catbird’s seat, because only four smaller states remain with evangelical voter majorities.

Source:
CHRISTIE, BUSH TRYING TO TAKE HIM DOWN
Rubio Now Winning the ‘Endorsement Primary’
3 days ago
WHY WE CARE

Since his strong third-place finish in Iowa, Marco Rubio has won endorsement by two sitting senators and two congressmen, putting him in the lead for the first time of FiveThirtyEight‘s Endorsement Tracker. “Some politicians had put early support behind Jeb Bush — he had led [their] list since August — but since January the only new endorsement he has received was from former presidential candidate Sen. Lindsey Graham.” Meanwhile, the New York Times reports that fueled by resentment, “members of the Bush and Christie campaigns have communicated about their mutual desire to halt … Rubio’s rise in the polls.”

Source:
7 REPUBLICANS ON STAGE
Carly Fiorina Will Not Be Allowed to Debate on Saturday
2 days ago
THE LATEST

ABC News has announced the criteria for Saturday’s Republican debate, and that means Carly Fiorina won’t be a part of it. The network is demanding candidates have “a top-three finish in Iowa, a top-six standing in an average of recent New Hampshire polls or a top-six placement in national polls in order for candidates to qualify.” And there will be no “happy hour” undercard debate this time. “So that means no Fiorina vs. Jim Gilmore showdown earlier in the evening for the most ardent of campaign 2016 junkies.

Source:
×