AGA Washington Insider

A policy blog for GIs

SGR Repeal Legislation Passes House, But Pay-For Makes It DOA in Senate

After months of bipartisan collaboration in both chambers of Congress, the SGR Repeal and Medicare Provider Payment Modernization Act succumbed to the partisan bickering that seems to kill so many bills.

The three committees with jurisdiction over Medicare physician services have worked over the past year to come to an agreement over the policy on how to repeal the sustainable growth rate (SGR) and transition physicians to a more value-based payment system. Both Democrats and Republicans agreed with the policy, and the bill, H.R. 4015/S. 2000, was unanimously voted out of the Senate Finance Committee, the House Energy and Commerce Committee, and the House Ways and Means Committee. However, talks appear to have broken down on how to pay for the repeal, which, ironically, is at its lowest point in years — $138 billion over ten years.

The AGA is disappointed that such a collaborative, bipartisan process has become politicized, yet we continue to call on Congress to keep the momentum going and not to lose progress on an issue that is so critical to organized medicine and patients. AGA continues to call on Congress to enact H.R. 4015/S. 2000 in this session so that we can get the SGR behind us and focus on other issues that are vital to physicians and their patients.

Pay-Fors
The leaders of both chambers decided to come up with their own “pay-fors.” House leadership decided to repeal the individual mandate of the Affordable Care Act for five years to pay for the SGR bill. The House passed H.R. 4015 by repealing the individual mandate as a financing mechanism with mostly Republican votes. The Senate Democratic leadership has indicated that approach is dead on arrival in the Senate.

Senate leadership plans to bring up the bill during the last week in March, but will pay for it by using the overseas contingency operations account, funds that would have been used to fund war operations in Iraq and Afghanistan. Many Republicans oppose this approach, calling it a budget gimmick.

Physician Community Collaboration
Last week, I attended a meeting of the physician community convened by the newly appointed Senate Finance Chair Ron Wyden’s staff. During the meeting, Sen. Wyden’s staff voiced their commitment to getting this legislation over the finish line and asked for the physician community’s help in making that happen. They also indicated that they need for both chambers to pass a version of the bill so that they can get to conference and iron out their differences.

We will continue to update you on any new developments in AGA eDigest and the AGA Washington Insider.

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