After a permanent repeal of the sustainable growth rate (SGR) formula passed the House of Representatives in late March, the measure's backers in the Senate work to quell a potential revolt from Senate conservatives over its initial $214 billion price tag, according to Reuters.
Some Senate Republicans, such as Jeff Sessions (R-Ala.), want the measure paid in full before they pass it, noting that the Congressional Budget Office projects it will add $141 billion to the national debt over the next 10 years. This faction also points to an analysis by the non-partisan Committee for a Responsible Federal Budget, which has cautioned against a permanent fix, indicating it would add a half trillion dollars to the deficit in the next 20 years. One such senator, Mike Lee (R-Utah), will likely add an amendment to require Congress to find a way to cover the costs by the end of the year.
Echoing these sentiments, a report from the National Center for Policy Analysis criticized the cost and scope of the bill, arguing the price tag indicated Congress has "abandoned budget neutrality, a commitment made previously by both parties." The report laid out alternate possibilities for a doc fix, including a two-year SGR patch and finding offsets for the eventual $141 billion pricetag.
Senate Majority Leader Mitch McConnell (R-Ky.) says he expects the Senate will permanently repeal the SGR this week to prevent automatic cuts in Medicare payments to doctors that will take effect April 15 absent a fix. But senators on both sides of the aisle call for more scrutiny and further amendments to the bill. For example, Senate Democrats seek to amend the bill to double the two years of funding included for a children's health insurance program, the Wall Street Journal reports.
"There are a number of senators who want to be heard on this issue and there ought to be an opportunity for them to weigh in," Sen. Ron Wyden (D-Ore.), who plans to vote for the bill, said last week, according to the WSJ.
Despite the successful passage of the bill in the House, healthcare experts say the measure doesn't provide enough specifics. For example, the legislation does not establish which care quality metrics Medicare will use to determine payments in lieu of the SGR, FierceHealthcare previously reported.