Others see another purpose: a launching pad for trial balloons on changes that might pay for the SGR's costly repeal, which the CBO estimates will cost about $139 billion over 10 years.
“I think that the committees are floating these ideas exactly for that purpose, to signal potential offsets and gauge pushback,” Eric Zimmerman, a partner with McDermott, Will and Emery, said in an e-mail.
For instance, the 10-page paper notes that modernizing the Medicare program could begin by establishing a single combined annual deductible for Medicare parts A and B and simplifying a coinsurance rate for spending above that deductible. The paper—which also examined the growth in supplemental coverage and its impact on Medicare costs—noted that Medicare cost-sharing and supplemental coverage reforms have received bipartisan support from groups including the American Enterprise Institute, the Brookings Institution and the Bipartisan Policy Center..
As lawmakers weigh a permanent fix to the SGR or another short-term patch, they do so as they ready themselves for budget battles in the weeks ahead. Those include finding a way to continue funding government operations after the fiscal year ends on Sept. 30 and dealing with the debt ceiling—the Treasury department estimated this week that the nation will reach its debt limit by mid-October.
“I think that's going to have a profound influence again on Medicare spending,” Zimmerman said in an interview, referring to the negotiations over the debt ceiling and funding the government. “All of that could—and probably will—result in finding some Medicare offsets. SGR could be tied up in that.”