With all eyes on the politics of Tuesday's elections, the nation's largest doctors lobby is reminding Congress of an imminent policy battle: how to prevent a looming Medicare cut for the country's physicians.
The American Medical Association (AMA) is warning of "a catastrophe" if lawmakers don't step in to block the 23 percent cut, which is scheduled to take effect Dec. 1, and another 6.5 percent cut that's due a month later.
"If physicians cannot keep their doors open because Medicare now only pays about half the direct cost of running a practice, then we're going to lose access to care," AMA President Cecil B. Wilson said in an interview with Kaiser Health News. "It will be gut-wrenching for physicians to say, 'I can no longer continue to see new Medicare patients.' … But that's where we are, and if you're talking about a 30 percent cut if Congress does nothing by Jan. 1, this will be a catastrophe."
But fixing the so-called Sustainable Growth Formula (SGR) won't be easy. Delaying the cut until the start of 2012 would cost about $15 billion, Kaiser reports, citing an April estimate from the Congressional Budget Office, while a 10-year fix would require lawmakers to come up with $276 billion.
The AMA, under pressure from anxious members, is urging Congress to provide a 13-month fix in the lame-duck session.
"Our strategy is to say to Congress, 'What we want from you is to stabilize Medicare payments to physicians for the next 13 months to get us through 2011,'" Wilson told Kaiser. "That will give us an opportunity working with the new Congress to develop a means of getting rid of the formula, putting in a formula or a payment mechanism that recognizes increased costs of care."
House lawmakers last year passed a bill that scrapped the SGR and erased the cuts dictated under the formula, but the measure wasn't offset by budget cuts or revenue increases elsewhere in the budget. Fiscal conservatives in the Senate killed a similar bill a few days later, leaving lawmakers to return to the perennial game of passing short-term updates instead.