Letter to the Joint Select Committee on Deficit Reduction


By:  John Yarmuth Tom Latham Marcy Kaptur Mike Honda Frank Pallone, Jr. Gary Ackerman Earl Blumenauer Eleanor Norton Joe Courtney André Carson Henry Cuellar Mike Doyle Chaka Fattah, Sr. Joe Heck, Jr. George Miller John Garamendi Lois Capps Danny Davis Anna Eshoo Sam Farr Elijah Cummings Ed Perlmutter Phil Roe Keith Ellison Jesse Jackson, Jr. Dennis Cardoza Gary Peters Donald Young John Dingell Chris Murphy Robert Aderholt John Carter Dan Burton Doris Matsui Walter Jones, Jr. Bill Owens Albio Sires Charlie Gonzalez Peter DeFazio Mike Thompson Dennis Ross Rubén Hinojosa, Sr. Carolyn Maloney Bruce Braley Diana DeGette Gregory Meeks Loretta Sanchez Ed Markey Carolyn McCarthy Chellie Pingree Jan Schakowsky John Tierney Peter Welch Mike Fitzpatrick Steve Rothman Lacy Clay, Jr. David McKinley Pete Stark Reid Ribble Barney Frank Gerry Connolly Betty Sutton Tim Bishop Brian Bilbray Donna Christensen Silvestre Reyes Charlie Rangel Bill Young Karen Bass Howard Berman Paul Tonko John Carney, Jr. John Lewis Paul Broun Lynn Woolsey Judy Chu Laura Richardson Nick Rahall II Dennis Kucinich Joe Crowley David Price Dutch Ruppersberger Jim Himes Tim Walz Yvette Clarke Mike Michaud Maurice Hinchey Henry Waxman Lou Barletta Bob Filner Susan Davis Bill Pascrell, Jr. Marcia Fudge Jim McDermott Richard Neal Elton Gallegly Kevin Yoder Ben Chandler III Cedric Richmond Jackie Speier Gene Green Ed Towns Pat Meehan John Conyers, Jr. Mark Critz Allyson Schwartz
Date: Oct. 6, 2011
Location: Washington, DC

U.S. Rep. Allyson Schwartz, along with 113 Members of Congress, sent a bipartisan letter to the Joint Select Committee on Deficit Reduction today, urging the Committee to repeal the Medicare physician payment system known as the "sustainable growth rate" or SGR.

"For over a decade, the existing Medicare physician payment system has created uncertainty and instability, not only in the health care system, but in the larger economy," Schwartz said. "As we begin to transform our health care system to improve quality and reduce costs, we must first stabilize reimbursements. The Joint Select Committee has a historic opportunity to take concrete action to move beyond a policy that has failed taxpayers, Medicare beneficiaries, and those on the front line of patient care. The overwhelming bipartisan support for this letter speaks to the urgency and importance of tackling this issue now. True deficit reduction cannot be achieved without first addressing the significant debt in our nation's largest health program."

"To ensure patient access to physician care, we must permanently fix the Medicare sustainable growth rate formula (SGR)," said Rep. Phil Roe (R-TN), one of 21 Republicans to sign on to the letter. "Physicians are currently threatened with a 29.5 percent cut in their payments unless Congress can end these budgetary games. A cut of this magnitude would leave many, if not most, Medicare patients without access to physicians. Fixing the SGR will help bring stability to our medical system."

October 6, 2011

Honorable Patty Murray Honorable Jeb Hensarling

U.S. Senate U.S. House of Representatives

Washington, DC 20510 Washington, DC 20515

Honorable Max Baucus Honorable Dave Camp

U.S. Senate U.S. House of Representatives

Washington, DC 20510 Washington, DC 20515

Honorable John Kerry Honorable Fred Upton

U.S. Senate U.S. House of Representatives

Washington, DC 20510 Washington, DC 20515

Honorable John Kyl Honorable James Clyburn

U.S. Senate U.S. House of Representatives

Washington, DC 20510 Washington, DC 20515

Honorable Rob Portman Honorable Chris Van Hollen

U.S. Senate U.S. House of Representatives

Washington, DC 20510 Washington, DC 20515

Honorable Patrick Toomey Honorable Xavier Becerra

U.S. Senate U.S. House of Representatives

Washington, DC 20510 Washington, DC 20515

Dear Colleagues:

On behalf of Medicare beneficiaries and taxpayers across the nation, we urge you to include a long-term solution to the broken Medicare physician payment system as an integral component of any deficit reduction proposal set forth by the Joint Select Committee on Deficit Reduction. For a decade, the fundamentally flawed Medicare physician payment system has created uncertainty and instability not only in the health care system but in the larger economy. Through this deficit reduction process, Congress has an historic opportunity to implement sound fiscal policy in the Medicare program in the context of broad economic reforms.

As you know, the Balanced Budget Act of 1997 created the sustainable growth rate formula (SGR) in an attempt to control spending in the Medicare program. For ten years, this methodology has consistently produced unrealistic expenditure targets, which subsequently trigger untenable reductions in payment rates.

For far too long, we have buried the true cost of this failed policy through annual Congressional overrides of these scheduled cuts. Each of these short-term "fixes" have achieved the most important goal of averting an immediate crisis in access to physicians for Medicare beneficiaries--while exacerbating a longer-term crisis in Medicare financing.

On January 1, 2012, physicians face a scheduled reduction in Medicare payments of nearly 30 percent. We are presented with an important choice: continue to distort the picture of our nation's fiscal status with another short-term solution or restore fiscal transparency to the Medicare program by eliminating the $300 billion debt that has accumulated as a result of the SGR.

We urge you to include a full repeal of the SGR, to stabilize current payment rates to ensure beneficiary access in the near-term, and set out a clear path toward comprehensive payment reform. Failure to take advantage of this opportunity to permanently address the SGR means that the cost of a remedy over five years could double to nearly $600 billion.

We join together to urge bipartisan Congressional action to put an end to the fiscal irresponsibility that has defined Medicare payment policies for a decade. True deficit reduction cannot be achieved without addressing the significant debt in our nation's largest health program. The sustainable growth rate must be repealed and replaced by a payment system that promotes efficiency, quality and value and ensures access to medical services for Medicare beneficiaries.

We appreciate your attention to this issue and look forward to working with you as you prepare your deficit reduction plan.


Allyson Y. Schwartz Phil Roe, M.D. Henry Waxman

Pete Stark John Dingell Anna Eshoo

Frank Pallone, Jr. Dan Burton Walter Jones

Lois Capps Peter DeFazio Sam Farr

Joseph Crowley Patrick Meehan Mark Critz

Henry Cuellar André Carson Joe Courtney

Barney Frank Lynn Woolsey Dennis Ross

Marcy Kaptur Richard Neal David McKinley

Danny K. Davis Steve Rothman Bill Owens

William Lacy Clay, Jr. Chris Murphy Mike Doyle

Tom Latham Bruce Braley Eleanor Holmes Norton

Betty Sutton David Price Edolphus Towns

Carolyn Maloney Jim Himes Mike Michaud

Donna Christensen, M.D. Marsha Fudge Susan Davis

Charlie Gonzalez Mike Honda Bob Filner

John Carney Reid Ribble Silvestre Reyes

Jim McDermott Bill Pascrell John Lewis

John Conyers, Jr. C.W. Bill Young Vicky Hartzler

Nick Rahall John Carter Dennis Cardoza

Yvette D. Clarke Gary Peters Brad Miller

Todd Akin C.A. Dutch Ruppersberger Russ Carnahan

Lou Barletta Jackie Speier Brian Bilbray

Laura Richardson Peter Welch Mike Fitzpatrick

Mike Thompson Elton Gallegly Albio Sires

Paul C. Broun, M.D. Robert Aderholt Ben Chandler

Jesse Jackson, Jr. Gerry Connolly John Yarmuth

Chellie Pingree Jan Schakowsky Tim Bishop

Gary Ackerman Doris Matsui John Garamendi

Dennis J. Kucinich Charles B. Rangel Joe Heck, DO

George Miller Judy Chu Ed Perlmutter

Karen Bass Keith Ellison Chaka Fattah

Gene Green John Tierney Paul Tonko

Earl Blumenauer Linda Sanchez Gregory W. Meeks

Hank Johnson Cedric Richmond Elijah Cummings

Jerry Costello Maurice D. Hinchey Tim Walz

John Tierney Ed Markey Ruben Hinojosa

Carolyn McCarthy Don Young Diana DeGette

Howard Berman Kevin Yoder

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