ObamaCare bill gets chilly reception

Powerful physician groups that are Washington’s loudest voice for a permanent “doc fix” are shooting down a Republican effort to link the bill to a delay of ObamaCare’s individual mandate.

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Doctors have lobbied aggressively for legislation that would repeal a flawed Medicare payment system that Capitol Hill has periodically patched since the 1990s.

House Republican lawmakers have set a vote for next week on a bill that could cover the $150 billion cost of the “doc fix” by ending the controversial mandate to have insurance — setting up a tough vote for Democrats who have mostly stood by President Obama’s signature program.  

Lobbyists for the medical profession said the ObamaCare connection isn’t helpful because the permanent doc fix can’t happen unless the parties work together.

“The only way this is going to get done if it's done in a bipartisan fashion,” said Christian Shalgian, director of advocacy and health policy for the American College of Surgeons. “I don't think this pay-for was developed in a bipartisan fashion.”

The current patch of the formula expires on March 31, which could leave doctors facing deep cuts in their pay. Physician groups have been the most vocal supporters of a permanent repeal of Medicare’s Sustainable Growth Rate (SGR) formula, but some say that they cannot support the GOP gambit against the Affordable Care Act.

“We cannot support linking SGR repeal to changes in current law that will result in fewer people getting health insurance coverage,” said Molly Cooke, president of the American College of Physicians, in a statement on Friday.

Doctors’ powerful trade associations huddled with Senate Majority Leader Harry Reid (D-Nev.) on Thursday to discuss the doc fix bill. Attendees for that meeting included representatives for the American Medical Association (AMA), the Physicians and the Surgeons.

“It was a positive conversation with Sen. Reid,” Shalgian said, refusing to elaborate further on the powwow with the Senate leader. 

AMA confirmed their group was part of Reid’s sit-down about the doc fix. The prominent medical trade group said it is continuing efforts to work with Reid, Senate Republicans, and House members from both parties to enact permanent reform.

Other lobbyists urged Democrats and Republicans to enter negotiations to find a feasible pay-for to end the doc fix.

“We call on House and Senate leadership to immediately engage in a bipartisan process to reach bipartisan agreement on a budgetary solution that can pass both the House and the Senate,” Cooke said.

The permanent doc fix bill was announced with much acclaim last month as both Democratic and Republican leaders of the Senate Finance, House Energy and Commerce and Ways and Means committees signed off on a framework. But lawmakers have since struggled how to pay for the final fix, with advocates for hospitals and seniors warning Congress not to touch funding for their favored government programs.

On March 1, the Coalition to Protect America’s Health Care, made up of hospitals, launched a month-long ad campaign at the Capitol South and Union Station Metro stations telling Congress to “stop hospital cuts.”

But the backlash by hospitals might not be enough to protect them from the budget ax. The newly-installed chairman of the Senate Finance Committee, Sen. Ron Wyden (D-Ore.), told a gathering of the Federation of American Hospitals this week that “tough budget calls” will be made to end the doc fix.

Doctors also have been active in lobbying. The American Medical Association hosted its national advocacy conference in Washington this past week, bringing in hundreds of physicians to meet with lawmakers.

They were pushing members to sign onto the doc fix bill, which has attracted support from both parties with 83 co-sponsors in the House and three in the Senate.

The lobbying push for the fix will ramp up in the last week of March, when hundreds of surgeons will descend on Washington to visit congressional offices, according to Shalgian.

The bill in question would end the SGR, raise doctors’ pay for five years and create incentives for doctors to move to new payment models, shifting the healthcare system away from fee-for-service. 

Doctor groups have heralded the bill’s approach and have lined up behind it. Dr. Andrew Warshaw, president of the Surgeons’ group, said physicians have been divided in the past over ObamaCare and other healthcare issues but see enough good in this legislation to provide unified support.

“What is close to unique about this moment of time is everybody agrees now’s the time to get this done,” said Dr. Warshaw, also of Massachusetts General Hospital.

“There’s enough that we do agree on, enough to say grace over, that we ought get to it.”