House passes doc fix; Obama pledges support

The House of Representatives passed a bipartisan, permanent repeal of the Sustainable Growth Rate (SGR) formula today in a 402-12 vote.

President Barack Obama also indicated his intention to sign the "doc fix" bill into law, telling healthcare leaders yesterday, "I've got my pen ready to sign a good, bipartisan bill."

[UPDATE: No Senate SGR fix vote until mid-April]

However, supporters of the legislation still must secure the necessary votes in the Senate before a two-week recess, set to begin next week, that would overlap with the March 31 deadline. If the Senate fails to vote or the bill doesn't pass, the automatic 21 percent reimbursement cuts under the SGR formula will take effect on April 1. 

Senate Democrats worry that language in the bill may restrict abortion services at community health centers, according to NPR. However, House Minority Leader Nancy Pelosi (D-Calif.), who led negotiations, has said the bill does not impose any further abortion restrictions, and the chairs of the 170-member House Pro-Choice Caucus have pledged their support to the fix. Sen. Joe Manchin (D-WV) told the New York Times he is working to marshal support for the bill in the Senate among "a group of moderates who will look at this as a way to fix something that's been a thorn in everyone's side for 17 years."

The bill is the most significant Medicare reform in two decades, Rep. Phil Roe (R-Tenn.), chairman of the House Republican Doctors Caucus and a player in the House negotiations, told NPR.  "I can almost say that with this passage I will have had a successful congressional career up to date. I really believe it's that important," he said.

There are also lingering concerns over the cost of the fix, estimated at $210 billion over the next 10 years. The legislation would add more than $140 billion to the federal budget deficit, despite cuts to certain provider payments and a premium hike for wealthier Medicare beneficiaries, according to NPR.

But trade groups like the American Medical Association (AMA) and the Medical Group Management Association (MGMA), said in statements sent to the press today that they plan to push the Senate to repeal the unpopular formula. MGMA President and CEO Halee Fischer-Wright, M.D., referred to the SGR as a "dark cloud of financial uncertainty" over physician group practices that has hampered Medicare innovation. 

AMA President Robert M. Wah, M.D., said in a statement that "the time is now to finally lay this destructive issue to rest and act immediately to build a stable and sustainable Medicare program that our nation's patients and physicians need and deserve."

To learn more:
- here's the House vote
- read the NPR article
- check out the New York Times article
- here's the AMA statement