(Updated to incorporate new information from the Congressional Budget Office's score of the doc fix bill)
In lieu of a permanent agreement and with the deadline approaching in five days, new legislation has emerged in the House to extend the "doc fix" and other health extenders for a year. This legislation would avert a 24 percent cut in Medicare physician payments due in April from the Sustainable Growth Rate (SGR) formula, instead freezing physician payments through March 2015.
The end goal remains a permanent replacement of the SGR formula, but with no agreement reached on pay-fors and three of the four proposals either offsetting the costs with gimmicks or simply ignoring its costs altogether, lawmakers appear ready to move a host of smaller Medicare reforms to pay for another temporary patch.
Proposals to "pay for" (or not pay for) a repeal of the Sustainable Growth Rate (SGR) formula have come out this week, and the verdict has been mostly not good.
To bolster their case against offsetting the high cost of SGR reform, many have claimed that the Medicare Sustainable Growth Rate (SGR) is “budget fakery” and represents “savings that aren’t going to be realized.” Yet while it’s true most SGR cuts have not gone into effect as scheduled, that doesn’t mean the SGR hasn’t helped to control health care costs.
Note: This blog has been updated from its original posting to include the CBO score of the Senate Republican proposal.
Earlier today, we wrote that the the House Republican SGR bill would add to long-term deficits by using a timing gimmick to pay for permanent costs with temporary savings. It turns out, a Democratic alternative introduce by Rep. John Tierney (D-MA) would replace this gimmick with another – the war spending gimmick.
While the relevant congressional committees recently reached agreement on a bipartisan plan to replace the Sustainable Growth Rate (SGR) formula with a payment structure to better incentivize high-quality, higher-value care, the question of how to pay for that reform remains unresolved.
We talked last week about several policies making their first appearance in the President's budget. What we didn't mention is that in addition to introducing new policies, the President has dropped a few old ones. Among the policies the President had previously proposed but did not include in this year's budget are: