Good analysis of the docs’ next steps after the supercommittee failed to draft a package…
Politico Pro’s Matt DoBias and KHN’s Mary Agnes Carey examine what led to the super committee’s failure to cut a deal and discuss what it means for hopes of a permanent “doc fix.”
MARY AGNES CAREY: Physician groups had really hoped to get a sweeping “doc fix” as part of a super committee deal. That’s not in the cards now, so what’s their next move to stop a payment cut of nearly 30 percent in January?
MATT DOBIAS: I think their best bet for a full repeal had to have come from the super committee; obviously that’s not going to happen. And so, moving forward, they have to get the fix. We know that Congress always steps in at the eleventh-hour, at the 11:30th hour sometimes, they’re able to make this deal - and they’ve even done it retroactively.
But as one health care lobbyist told me today, this now marks the return to regular order. And what he means by that is this idea of the doc fix – reversing these double-digit pay cuts that kick in Jan. 1 – is going to go through the committee process like it typically does. And this is going to be on the House side: the Energy and Commerce and Ways and Means Committees. On the Senate side it’s going to be Finance.
It’s not going to be the full repeal that they wanted; that’s got a $300 billion price tag attached to it. And really, that money really could have only come in the broader deficit-reduction scheme. So you’re looking at now anywhere from a one to three year patch.
Now, there are several proposals, and lawmakers from both sides of the aisle have really been working on ways to creatively get them their doc fix. Some of those proposals include one to two, maybe even three years of stable payments while physicians test out new payment models, new practice models – kind of moving towards something that is different than this dreaded SGR, the sustainable growth rate, which is the Medicare formula that leads to these cuts, year-in and year-out for physicians.
The trade-off is that they’re not getting the full repeal that (it’s not just physician groups) I think any health care group and pretty much any member of Congress will tell you that they would like to have. That money just simply isn’t there outside of the super committee. But I’ve been assured that there are “pay-fors” out there finding the right calibrations to pay for this. This is going to be anywhere from a mid-$20 to high $30 billion fix. Lawmakers will tell you that there are “pay-fors” that are out there; it’s just a matter of finding the right mix.
