Goodbye to the SGR

Op-Ed

By Rep. Joe Pitts

Congress is infamous for putting things off. It always seem easier to do something tomorrow. Maybe the next year there will be a different President, or a different Senate, or a different House. Or maybe, one day there will be enough money to pay for everything that everybody wants. The reality is that you can always come up with a reason not to do something.

Back in 1997, Congress was on the cusp of balancing the federal budget for the first time in decades. For four years, the federal government would actually have a surplus. However, budget experts predicted that the growth in Medicare would soon put the government back in the red.

President Clinton and Newt Gingrich reached an agreement to control the growth in Medicare spending through a new mechanism called the Sustainable Growth Rate. It was basically a blunt instrument that would hold doctors' reimbursement rates down regardless of the actual cost of providing care.

The cuts called for by SGR were simply too deep and could have led doctors to simply stop treating Medicare patients. Projected SGR reductions of near 5 percent soon grew to more than 10 percent and then more than 20 percent. From 2003 on, Congress has delayed the cuts and in some cases increased reimbursements instead. There were 17 of these delays in the last dozen years.

The "Doc Fix" bills became an annual ritual in Congress. Physicians and lobbyists would come to the Hill begging not to be cut and Congress would oblige. For years, there was no serious effort to fix the problem.

Democrats promised doctors and medical societies that their massive health reform bill would fix the problem. Instead, it was dropped from Obamacare as too costly and another patch was passed.

When Republicans took back the House and I took over leadership of the Energy and Commerce Health Subcommittee, I made it one of my priorities to finally end the uncertainty of patchwork bills and get a permanent fix. Full committee Chairman Fred Upton (R-MI) and Speaker Boehner shared this vision.

In May 2011, I chaired the first hearing of the Health Subcommittee to look at the Medicare payment system. It took years of work involving outreach to stakeholders, careful construction of a new policy, and negotiation with Democrats but in 2013 we finally reached an agreement on the Energy and Commerce Committee.

Last year, we passed this bill in the House with a package that paid for the costs of reform by reductions in Obamacare spending. Unfortunately, this package went nowhere in the Senate and was threatened with a Presidential veto.

Another temporary patch was passed in the spring, one that is set to run out March 31. With that deadline approaching, something had to be done. House Democrat and Republican leaders negotiated a new package of ways to pay for the new Medicare reimbursement system.

These methods of paying for permanent SGR repeal represent the first real entitlement reform considered in the Obama administration. Over the course of the coming decades, they will save $295 billion. The negotiated bill also contains an extension of the State Children's Health Insurance Program and funds for Community Health Centers.

It's not a perfect bill, but I believe it represents an honest and fair compromise. I'm not the only one who feels this way. The House of Representatives passed H.R. 2, the Medicare Access and CHIP Reauthorization Act of 2015, by a vote of 392-37.

This has been years in the making, but we can finally stop passing the buck and permanently repeal the SGR. Now that the House has acted, the Senate needs to pass the bill and send it to the President, who has indicated that he will sign it.

It is satisfying to see a long-term goal finally accomplished. It took dedication and persistence. It took negotiation and compromise. Now there is much more work to be done.

Fixing the SGR is not saving Medicare. It places the program on a better footing, but it does not prevent the Medicare trust fund from running dry in just over a decade. I hope that this achievement can build trust and allow us to go further, preserving Medicare for future generations.

Source