Fiscal cliff threatens Medicare--again

Facing another fiscal cliff, President Obama today reinforced the urgency of the sequester that will take effect March 1--10 days from now. To fend off the automatic cuts to most domestic federal programs, including a 2 percent cut to Medicare providers, Obama favors spending cuts in Medicare and Medicaid, as well as new tax revenue by reducing tax breaks for the wealthiest Americans, The Washington Post reported.

Signs indicate Congress will let the automatic cuts go into effect. Without a long-term solution, Obama is asking for a short-term stopgap measure to delay the automatic cuts, the newspaper noted.

Also known as "Obamaquester" in GOP circles, the sequester is an automatic mechanism, designed to control spending, that Congress and the president signed with the Budget Control Act of 2011. However, they essentially left the problem to their future selves to deal with. That time has come, as the cuts are scheduled to kick in next week.

In the meantime, Congress is on Presidents Day recess until next week.

Among other worries, Medicare providers are still looking at an additional 25 percent cut with the sustainable growth rate formula, scheduled to hit next year.

The House Energy and Commerce Health Subcommittee on Thursday met to discuss options for repealing the SGR, including a GOP plan that would offer defined payment rates for a period of years before moving to quality- and efficiency-based payments, MedPage Today reported. The American College of Physicians proposed a five-year period between ending the SGR and the move to quality payments.

"We need to bring an end to constant uncertainty for doctors and patients," HHS Secretary Kathleen Sebelius said last week, American Medicare News reported.

The American Hospital Association has said it recognizes the need for Medicare reform. AHA supports raising the Medicare eligibility age to 67, citing new health coverage protections for seniors starting in 2014, and modifying Medigap plans to avoid unnecessary use, among other recommendations, according to a letter to the Senate.

For more information:
- see the Washington Post article
- read the MedPage Today article
- read the amednews article
- see the AHA letter (.pdf)

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