Achieving a Better Life Experience Act of 2014

Floor Speech

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Mr. LARSON of Connecticut. Mr. Speaker, I rise today in strong support of the ABLE Act. I would like to commend the efforts of my colleagues Representative Ander Crenshaw and Representative Chris Van Hollen for their leadership and steadfast commitment to moving this legislation forward. This is truly a great bipartisan effort that will help families across this country and I've been proud to join the hundreds of members of Congress who support it as a cosponsor.

For years, I have heard from constituents like Andrew and Tamara Selinger from West Hartford, who have advocated not only on behalf of their own family, but for families across Connecticut and the country. Their two children have Fragile X syndrome and all they are asking for are the same opportunities for their children that other families have with the 529 plan, to have a savings mechanism that would enhance their lives and pay for non-covered medical expenses, while not minimizing the services that they receive. I have heard from people like Bob and Rosie Shea and Shannon Knall from our local Autism Speaks chapter and many others from families and groups advocating on behalf of individuals with disabilities, who have spoken so passionately about why this legislation is so important.
In spite of the partisan rancor that often dominates this building, this bill shows that we can come together in a meaningful way to act in a positive manner on behalf of the American people. It is truly inspiring how many advocates and families have made their voice heard on this legislation and I urge my colleagues to support this bill and finally get it across the finish line on behalf of families across this country.

Mr. PRICE of Georgia. Mr. Speaker, I strongly support the ABLE Act and its intent to promote greater independence and freedoms to disabled and handicapped Americans. However, I have great concerns with the policy that is being used to pay for this legislation because it would seek to further decrease Medicare reimbursement for physicians--an action that could threaten seniors' access to health care.

Since the passage of the Medicare Modernization Act of 2003 and the creation of the sustainable growth rate (SGR) formula, Congress has passed 17 ``doc-fixes'' to prevent further cuts to physicians providing care for our seniors. Each year, the entire medical community must pick up the tab to prevent the disastrous cuts that would be implemented if the SGR was to take effect. The result? Medicare reimbursement for physicians has decreased by 17% when adjusted for inflation, while the cost of care continues to rise.

In the most recent ``doc fix'' passed in March of this year, a controversial provision required the annual re-evaluation of codes matching 0.5% of total physician spending from 2017 through 2020. If this target is not met, the difference would be taken in the form of an across the board cut. The proposed offset included in the ABLE Act would shift these targets forward and compress them, requiring CMS to identify misvalued services equal to at least 1% of total physician spending in 2016, and 0.5% in 2017 and 2018. Moving the target to 2016 and frontloading it to require the identification of 1% of total physician spending in the first year would make it extremely difficult to meet the target.

However, CMS has no intention of implementing this law. In the 2015 Medicare Fee Schedule Final Rule, CMS finalized a proposal to transition 10- and 90-day global period codes to 0-day global period codes in 2017, and 2018, respectively, yet CMS has not developed a methodology for how that transition will be made. This is a major overhaul of close to half of the currently existing CPT codes and will dramatically reform how physicians are paid. Because CMS has not yet developed a methodology for how this transition will occur, the nature of the impact is currently unknown, leading to further instability in physician payments. CMS notes in the Rule that due to the work necessary to make this change, they will not have resources to review certain other potentially misvalued services for the ``next several years'', almost certainly resulting in an across the board cut to all physicians caring for Medicare patients.

This continuous pursuit by our Congress and CMS to re-evaluate codes within the physician fee schedule will be detrimental to the medical community and to ensuring access for our Medicare beneficiaries. A 1% cut may not sound like much, but when taken in conjunction with the combined maximum penalties for not meeting the PQRS, physician value-based payment modifier, and EHR programs, the total potential cut faced by physicians will be -9% in 2016, and -11.5% in 2017. This does not even take into account the cuts required by the unresolved SGR.

Despite these concerns, I will support the ABLE Act today with the hope that my colleagues on both sides of the aisle will recommit themselves in the new Congress to securing the Medicare program for all Americans.

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