WASHINGTON – With bipartisan agreement to repeal and replace the Medicare Sustainable Growth Rate formula already on the table, the next battle facing passage of the legislation will be how to pay for it.
Republican leadership of the House Energy and Commerce Health Subcommittee made it clear at a Jan. 21 hearing that a permanent SGR fix would not move forward without offsets to cover the estimated $140 billion price tag for the current agreement.
Alicia Ault/Frontline Medical News (file photo)
Rep. Joseph Pitts (R-Penn.)
Finding the offsets “will not be easy, but it is a task we must embrace,” Subcommittee Chairman Joseph Pitts, (R-Pa.), said in opening the first of two days of hearings on SGR repeal. “Some argue that SGR reform does not need to be paid for. I respectfully disagree.”
Rep. Pitts noted that 98% of enacted SGR patches, spanning 120 of the 123 months worth of so-called “doc-fix” legislation, have been paid for with offsets.
Democrats on the subcommittee were critical of that hard line, noting that the House recently passed a bill to change definition of full-time employment in the Affordable Care Act to 40 hours a week, a bill estimated to cost more than $50 billion, without any cost offsets. They also suggested to look elsewhere in government to find the offsets.
“But a fix to the SGR that harms Medicare beneficiaries because of the insistence of offsets that reduce benefits and limit access is not an acceptable tradeoff,” said the subcommittee’s ranking member, Rep. Gene Green, (D-Tex.).
Witnesses who testified on Jan. 21 agreed that it should not be passed without offsets, though the common message was not to put the burden on beneficiaries through higher premiums or reduction of services.
