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GOP Tries New Tactic in Attack on Obamacare's Mandate GOP Tries New Tactic in Attack on Obamacare's Mandate

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Health Care

GOP Tries New Tactic in Attack on Obamacare's Mandate

Republicans plan to tie a delay to measure that would address one of Medicare's most vexing flaws.

House Speaker John Boehner and Majority Leader Eric Cantor are set to push through the House yet another proposal to stop the Affordable Care Act's individual mandate requiring Americans to have health insurance or pay a penalty.(Mark Wilson/Getty Images)

photo of Clara Ritger
March 10, 2014

In the latest proposal to stall Obamacare's mandate that all Americans have health insurance, House Majority Leader Eric Cantor has scheduled a Friday vote to tie it to the permanent "doc fix."

The vote is on a bipartisan, bicameral proposal to repeal and replace the broken sustainable growth rate formula used to determine Medicare payments made to physicians. That proposal—also known as the permanent doc fix—has stalled as Congress searches for a way to pay for its $138 billion price tag.

GOP Rep. Michael Burgess of Texas is the sponsor of the House version of the bill, which carries a delay of the Affordable Care Act's individual mandate as its pay-for.

 

Delaying the individual mandate by one year would save $9 billion, the Congressional Budget Office estimates. That's because fewer people would have health insurance or enroll in Medicaid, saving the government billions of dollars as fewer people seek subsidies for insurance premiums or get care at all.

How long of a delay the legislation calls for in order to cover the cost of the permanent doc fix has yet to be announced. But the proposal is sure to be vetoed by the president if not shot down in the Senate.

Tying the SGR talks to the individual mandate further slows the negotiations on how to pay for the proposal, which had the American Medical Association in Washington last week to pressure congressional leadership to get it done.

If Congress does not reach agreement on the permanent doc fix by March 31, physicians who provide services to Medicare beneficiaries face a 20 percent pay cut.

Passing the legislation would be a big achievement for Congress, which has voted every year since 2003 to stop the cuts to doctors' pay that are mandated to take effect by SGR formula at a cost of roughly $150 billion. The permanent fix carries a lower price tag than in previous years, which is why key stakeholders such as the AMA and policymakers involved in the negotiations had been positive about the potential for a long-term solution.

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