Potential Senate Finance Committee changes could affect SGR negotiations

A potential leadership change at the Senate Finance Committee next year could provide another stumbling block for legislation to fully repeal Medicare's physician payment system.

As reports surfaced that President Barack Obama plans to nominate Senate Finance Committee Chairman Max Baucus (D-Mont.) as ambassador to China, some wondered how long the Montana Democrat will hold his current post—and what his departure will mean for the fate of congressional negotiations to repeal Medicare's sustainable growth-rate formula.

Baucus announced earlier this year that he'll retire at the end of the current Congress. But it remains unclear how soon the White House will make the announcement and when Baucus' Senate confirmation process would begin. At deadline, neither the White House nor Baucus' office had replied to requests for more information. Sen. Jay Rockefeller (D-W.V.), next in line to the position based on seniority, currently chairs the Senate Commerce, Science and Technology Committee and will also retire at the end of 2014. A representative for Rockefeller's office had not replied to a request for comment by deadline.

“There's no question that whoever takes the helm, Senator Rockefeller or Senator Wyden—and based on Senator Rockefeller's announced retirement and recent statements, it appears it will be Senator Wyden—they all support repealing the SGR,” said Eric Zimmerman, a partner with the law firm McDermott, Will and Emery who covers Medicare reimbursement. “But if he (Baucus) stays on through SGR to get it done, then that would create the most continuity, the least disruption,” he said. Zimmerman added that other senators may not have developed the kind of rapport and level of trust that Baucus has with House Ways and Means Committee Chairman Dave Camp (R-Mich.), with whom he has worked closely on tax reform.

The relationship with Camp is important because Camp heads the House Ways and Means Committee, which will work with both the Senate Finance and House Energy and Commerce Committees to negotiate a final SGR repeal bill in 2014. All three committees passed their own repeal bills in their respective panels this year. And it's not just inter-committee relationships that hang in the balance in Baucus' absence, but intra-committee bonds as well.

“(Senator) Baucus is a great champion and had an ability to work very well with Senator Hatch, and their staffs worked really closely together on the package that was moved out of Senate Finance Committee,” said Anders Gilberg, senior vice president of government affairs at the MGMA. Hatch (R-Utah) serves as the ranking member on the Senate Finance Committee. “That's not to say that may or may not continue, but it's a new hurdle on a path of many hurdles.”

If Baucus is confirmed as ambassador and leaves the Senate before his term is over at the end of 2014, Montana Gov. Steve Bullock, a Democrat, would get to choose who will take the seat until an election. According to news reports, a likely choice is Democratic Lt. Gov. John Walsh, who is already running for the Senate.

Follow Jessica Zigmond on Twitter: @MHjzigmond