Statement on Senate Action on SGR Today

Statement attributable to:
Molly Cooke, MD, FACP
President of the American College of Physicians (ACP)

Washington, March 31, 2014 — The Senate today followed the House of Representatives and voted for the 17th short-term Medicare SGR patch over the past 11 years rather than real and permanent physician payment reform. By voting for the patch, both the House and Senate failed to heed the unified call of physicians, on behalf of their patients, who believe that now is the time for the House and Senate to reach agreement on the bipartisan reforms that were agreed to by the leaders of the Medicare committees of jurisdiction.

ACP is the largest medical specialty organization and second-largest physician group in the United States, representing 137,000 internal medicine physicians (internists), related subspecialists, and medical students. Internal medicine physicians are specialists who apply scientific knowledge and clinical expertise to the diagnosis, treatment, and compassionate care of adults across the spectrum, from health to complex illness.

As we said last week in our letter to the Senate leadership, we cannot support another short-term patch. Instead, we firmly believe that enactment of permanent SGR repeal and reform, this year, by this Congress, is both imperative and achievable, because never before has there been agreement between the members of the House and Senate, and between Republicans and Democrats, on the policies to repeal the SGR and create a better Medicare payment system.

The Protecting Access to Medicare Act of 2014 is the 17th patch enacted over 11 years to temporarily halt impending SGR cuts, at a budget cost of over $150 billion. Each time, physicians and patients were told that this time, things will be different, that the temporary patch would give Congress the time it needs to achieve agreement on permanent reform. Why should physicians and patients believe that this patch will be different and result in permanent SGR repeal?

This one-year patch could give Congress the out it wants to push the entire issue of permanent SGR repeal and Medicare payment reform to the 114th Congress. The new Congress would then have to start over on crafting a permanent SGR repeal and Medicare payment reform bill that could clear the authorizing committees, pass both chambers, and be signed into law by the Presidentâ€"before the this latest proposed patch expires on March 31, 2015. It is more probable that this would result in the enactment of patch #18 at an additional budget cost of tens of billions of taxpayers' dollars and further destabilization of Medicare.

Today's vote in the Senate, and last's week unaccountable voice vote in the House, were votes for the status quo of holding health care for seniors, military families, and disabled persons on Medicare and TriCare hostage to an inherently flawed and destabilizing SGR formula, year after year after year. They were votes for the status quo of preserving a wasteful payment system that rewards volume instead of value.

We will be calling on our 137,000 members (voters) to tell their member of the House and their Senators that the Senate's and House's votes for a patch must not and cannot be the end of the line for permanent SGR repeal in the 113th Congress.

We again call on the committed members of Congress from both parties, in both chambers, who have worked so hard over the past year to reach agreement on a bipartisan bill to permanently repeal the SGR and reform physician payments, to do everything possible to get it passed, this year, by this Congress. We again call on the Senate to pass the legislation the bipartisan and bicameral legislation that was agreed to by the leaders of the Medicare committees. We again call on the House and Senate to enter into direction negotiations to resolve their differences over the budget impact of SGR repeal.

Congress's vote for a patch will not mark the end of ACP's efforts to press Congress to reach agreement on passing the bipartisan and bicameral SGR repeal bill that was agreed to by the leaders of the authorizing committees. Physicians and their patients will hold the 113th Congress accountable for delivering on permanent SGR repeal before the end of this year.

David Kinsman, (202) 261-4554,