Replacing Medicare’s sustainable growth-rate formula for paying doctors will top the agenda when Congress returns from spring break this week.
The Senate will consider a bipartisan bill the House passed last month, and nothing emerged during the recess to derail it. The $200 billion package includes a two-year extension of the Children’s Health Insurance Program and $7.2 billion for community health centers.
The biggest potential stumbling block is that only about $70 billion of the bill’s cost is paid for with spending reductions. Those cuts include increased premiums and cost sharing for Medicare beneficiaries and reduced payments to hospitals and long-term-care providers. The lack of full offsets doesn’t sit well with Senate Republican budget hawks.
It probably won’t help that the CMS actuary last week cautioned that the new payment system may well lead to inadequate doctor payment rates after 2049. That suggests future Congresses would again face the need for doc fixes.
But most policy watchers expect Senate Republican leaders to placate hardliners by allowing votes on amendments. The trick will be to make sure none of those amendments actually pass. If any do, the bill would have to be reconciled with the House version.
Time is tight. The CMS has delayed processing doc payments through April 15, staving off pay reductions of 21.2%. That leaves only two days for the Senate to take action.
“I do think that people understand the importance and the desirability of putting an end to this charade,” said John Rother, CEO of the nonpartisan National Coalition on Health Care.
