AMA making house calls to key districts

The American Medical Association (AMA) is broadening its campaign to pressure Congress to prevent a planned cut to Medicare payments by targeting key lawmakers in their backyards through advertising and local media.

The home districts of House Energy and Commerce Committee Chairman Joe Barton (R-Texas) and House Majority Leader Tom DeLay (R-Texas) were among the markets chosen by the AMA for the first wave of an effort that started in East Texas and will move westward across the state and ultimately will reach seven to nine states throughout the summer.

The AMA purchased radio ads in the Dallas, Houston and Texarkana areas that ran the week of June 6. The spots, which resemble news bulletins, identify themselves as “a special Medicare report” from the AMA and warn listeners that a scheduled payment cut next year will threaten Medicare beneficiaries’ access to doctors. A 5.2 percent cut is on tap for 2006 and similar annual reductions are scheduled through 2013 under the current formula used by Medicare to calculate reimbursements.

The AMA campaign will continue throughout the summer and into the autumn. The organization is holding its annual meeting in Chicago June 18-22. An expansion of its outreach campaign is expected after the meeting and would partially coincide with Congress’s Independence Day district work period.

The ads focus on the potential threat to patients’ access to care. “Unless Congress acts, Medicare payments for physician services will be cut by 26 percent — forcing doctors to limit the number of patients they can serve [and] even stopping doctors from accepting new patients,” the ad copy reads.

The ad urges listeners: “Call Congress today. … Tell them to fix the Medicare crisis.”

In conjunction with the advertising, the AMA joined with the Texas Medical Association and county organizations to hold so-called “AMA House Call” press conferences in Dallas, Houston and Corpus Christi. Local media were invited to cover the events. A press release announcing the events said they were intended “to draw attention to an imminent access to care problem for Texas’ seniors.”

The local focus on the payments issue does not replace the AMA’s lobbying efforts in Washington. And the organization’s recent successes on payments do not guarantee a win this time.

The AMA’s strategy appears to be whipping up public support for the multibillion-dollar proposition of boosting doctors’ payments. For several consecutive years, Congress forestalled other planned cuts, but the austere fiscal environment and the reluctance to open Medicare legislation to a slew of costly — but politically appealing — amendments mean the AMA’s challenge is greater this year.

The media markets selected for the opening salvo in Texas are in or near the home districts of six members of the House Energy and Commerce and Ways and Means committees. In addition to Barton, Energy and Commerce Committee members Ralph Hall (R), Michael Burgess (R) and Gene Green (D) are based in the vicinities of Dallas, Fort Worth and Houston. Ways and Means Committee members Sam Johnson (R) and Kevin Brady (R) represent parts of the Dallas and Houston areas, respectively.

Sen. Chuck Grassley (R-Iowa) is an obvious target for later stages of the AMA effort.

In addition to chairing the Finance Committee, Grassley represents the state with the fourth largest proportion of senior citizens in the country, according to the 2000 census. In Iowa, 14.9 percent of citizens are older than 65. Only in Florida (17.6 percent), Pennsylvania (15.6 percent) and West Virginia (15.3 percent) do seniors make up larger segments of the populace.

Moreover, Grassley told an AMA audience earlier this year that reforming the physician-payments system is one of his priorities, though he did not promise to take on the extremely pricey issue.

House Ways and Means Committee Chairman Bill Thomas (R-Calif.) has led the effort to stave off physician cuts over the past several years but it is unclear how he plans to proceed on the issue this year.

While the AMA has called for policymakers to scrap the entire payment system, such a move would cost more than $100 billion over 10 years.

The AMA public-relations campaign focuses on two bills that would address the payment issue, at least in the short term. The Preserving Access to Physicians Act of 2005 (H.R. 2356) was introduced by Rep. Clay Shaw (R-Fla.), a senior member of the Ways and Means Committee. The measure has 34 co-sponsors, include Ways and Means Committee Democratic Rep. Benjamin Cardin (Md.), Commerce Committee Republican Rep. Charlie Norwood (Ga.) and Commerce Committee Democratic Reps. Bart Gordon (Tenn.), Anna Eshoo (Calif.), Mike Doyle (Pa.) and Tom Allen (Maine).

A similar Senate bill (S. 1081) is sponsored by Jon Kyl (R-Ariz.) and Debbie Stabenow (D-Mich.). Kyl sits on the Finance Committee, which has jurisdiction over Medicare.

Congress is not expected to address doctor payments until the end of this year, possibly as part of a package of Medicare provisions that could include pay-for-performance incentives for physicians, changes to hospital payments and restrictions on physician-owned specialty hospitals.

A standalone bill is exceedingly unlikely, so supporters of these initiatives likely will have to seek a must-pass vehicle such as an omnibus appropriations bill. Although the GOP leadership in both the House and Senate have vowed to move all spending bills through regular order this year, many observers have predicted that the mismatch between the appropriations subcommittees in both houses and a plethora of hot-button issues will force Congress to accept an omnibus of some sort.