Although Democrats have pushed to permanently replace the Medicare physician payment formula as part of extending a package of expiring tax cuts, a senior Democrat indicated Tuesday that a permanent fix was unlikely.
Sen. Max Baucus (D-Mont.), the senior Democrat on the panel negotiating the tax package, downplayed the likelihood of permanently replacing the Medicare sustainable growth-rate formula when asked about it after the group's fourth meeting.
“That would be my preference but this is the art of the possible,” he told reporters when asked about a permanent SGR replacement.
Separately, Rep. Sander Levin (D-Mich.), another panel member, told reporters that he has not given up on the possibility of permanently replacing the SGR and that the Medicare physician payment issue was one of the only parts of the large legislative package on which there are any nonpublic discussions seeking common ground.
“On that, there have been discussions between Democrats and Republicans informally and my own suggestion was that we formalize it in terms of group discussions,” he said. “But one way or another, we're going to accelerate the back and forth.”
The Medicare physician payment formula is scheduled to impose a 27.4% cut if the bipartisan, bicameral panel negotiating the legislative package that would address it does not agree and get Congress to agree by the end of this month.
Members of the two parties appeared far apart on using any version of three House-passed proposals to pay for the SGR fix and other provisions of the legislation that were discussed Tuesday. Those so-called offsets included raising Medicare premiums for high-income enrollees and requiring insurance exchange enrollees who receive premium subsidies to pay back more of that assistance if their incomes increase during the year.
“It appears from the conversation today that the Democrats rejected the offsets that we had in our legislation,” said Rep. Dave Camp (R-Mich.), the senior Republican on the panel.
Instead of setting the next meeting date for the panel, Camp urged members to remain “flexible to be able to get together on a moment's notice.”