Practice Economics

House passes bill to repeal the SGR


The House of Representatives on March 14 approved a bill to repeal the Medicare Sustainable Growth Rate formula; the Senate is not likely to take up the bill.

The House voted mostly along party lines, with 226 Republicans and 12 Democrats voting in favor of approving H.R. 4015 and sending it to the Senate. Many Democrats who voted against it objected to the bill’s financing, which was achieved through a 5-year delay of the Affordable Care Act’s individual health insurance mandate.

Alicia Ault/ Frontline Medical News

House Minority Leader Nancy Pelosi (D-Calif.)

The Congressional Budget Office estimated that delaying the mandate would save about $170 billion over 10 years, while the Sustainable Growth Rate (SGR) fix would cost $130 billion in the same period. But the CBO also said that the plan would increase the number of uninsured by 13 million and lead to 10%-20% premium increases.

"Political games are threatening to derail months of bipartisan, bicameral progress" on implementing the Affordable Care Act, House Minority Leader Nancy Pelosi (D-Calif.) said in a speech before the vote.

"We shouldn’t be wasting time on this foolishness and this recklessness," she added, noting that securing a permanent fix before a 24% physician pay cut takes effect on April 1 was increasingly less likely as the Senate was not likely to approve the plan with the accompanying financing.

The House now is on break until March 25.

Dr. Ardis Dee Hoven, president of the American Medical Association, said that she was disappointed at the House action, given that the House and Senate had already agreed on the fundamentals of replacing the SGR. "It would be a shame for lawmakers to have done all of that hard work only to have it overcome by partisan politics over budgetary issues," she said in a statement.

Dr. Ardis Dee Hoven

"We thank all members who spoke on the floor in support of a return to bipartisan negotiations and encourage the United States Senate to proceed in a timely and bipartisan manner to advance legislation in that body," she said, adding that the AMA would continue to try to help forge a compromise.

"Continuing the cycle of kicking the can down the road through temporary patches in the months ahead simply wastes more taxpayer money to preserve a bad policy of Congress’ own making," Dr. Hoven said.

Leaders at other physicians’ organizations echoed Dr. Hoven’s disappointment.

"We’re dismayed that Congress sabotaged their own work by linking this legislation to unrelated, ideological issues – particularly in light of the nearly universal opposition to such action from patients, insurers, and the medical community," Dr. Reid Blackwelder, president of the American Academy of Family Physicians, said in a statement.

"It’s imperative that both parties come together to reach agreement on the budgetary payment that will pass both the House and the Senate before April 1," Dr. Blackwelder said.

Ms. Molly Cooke, president of the American College of Physicians, said the ACP stands by its statement from March 7. At that time, she said, "Congress knows that it is counterproductive for either the House or the Senate, Republicans or Democrats, to tie the bipartisan, bicameral SGR repeal bill to other policies that do not have the bipartisan support needed to pass both chambers, and be signed into law by the President."

Dr. Cooke added, "We cannot support linking SGR repeal to changes in current law that will result in fewer people getting health insurance coverage."

Rep. Fred Upton (R-Mich)

House Republican leaders called on the Senate to act.

"We have never come this far in finding a permanent solution," House Energy and Commerce Committee Chairman Fred Upton (R-Mich.) said in a statement. "But there is still much work to be done after today’s vote, and I call on my good friend Sen. Ron Wyden [D-Ore.] to pick up the torch and work with Majority Leader Harry Reid [D-Nev.] to put politics aside, stand up for our seniors and doctors, and solve SGR this year."

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