House vote raises prospects for another temporary doc-pay fix

Hopes that Congress would finally eliminate Medicare's troublesome physician payment formula were dashed Friday when the House voted to fund such a move by delaying penalties for not being insured called for in the Patient Protection and Affordable Care Act. With a Democratic-controlled Senate opposed to such a plan, the specter that another temporary fix for the sustainable growth-rate formula will surface became a strong possibility.

Congress will return from a weeklong recess on March 24, which will give lawmakers one week until the current temporary SGR patch expires March 31.

Under an amendment added by House Ways and Means Committee Chairman Dave Camp (R-Mich.), the House bill would keep the Affordable Care Act's individual mandate in place but would not penalize anyone for violating it until 2019. The Congressional Budget Office estimated this move would increase the number of uninsured Americans by about 13 million in 2018 and save $169.5 billion over a decade.

The SGR Repeal and Medicare Provider Payment Modernization Act passed 238-181 and picked up support from 12 Democrats. Though cheered by House Republicans, the legislation is viewed by Democrats, policy analysts and healthcare providers as purely a political move.

“We're dismayed that Congress sabotaged their own work by linking legislation to unrelated, ideological issues—particularly in light of the nearly universal opposition to such action from patients, insurers and the medical community,” Dr. Reid Blackwelder, president of the American Academy of Family Physicians, said in a statement reacting to the vote.

Senate Finance Committee Chairman Ron Wyden (D-Ore.), who introduced a version of the SGR repeal last week, said he is committed to sound, sensible policy over politics. The bill that Wyden introduced last week—the Medicare SGR Repeal and Beneficiary Access Improvement Act of 2014—includes the compromise agreement from the Senate Finance, House Ways and Means and House Energy and Commerce committees to repeal and replace the SGR, as well as the extension of certain Medicare programs that are expiring. It does not, however, include a way to pay for these provisions.

Follow Jessica Zigmond on Twitter: @MHjzigmond