Senate, House Disagree on How to Fund SGR Repeal Bill

As April 1 rapidly approaches, the pressure is building for Congress to find a bipartisan solution to fix the Sustainable Growth Rate (SGR) formula in order to avoid a 24 percent cut to Medicare payments. In February, H.R. 4015/S. 2000, a bill that would permanently repeal the SGR and put in place meaningful Medicare payment reforms, was unanimously approved by the members of the House Ways and Means and Energy and Commerce Committees, in conjunction with the Senate Finance Committee. With this bill, broadly supported by lawmakers in the House and Senate and most of organized medicine, we're the closest we've ever been to permanently repealing the flawed formula and replacing it with a new Medicare payment system that would reward high quality, evidence-based care. However, the House and Senate are in disagreement over how (or whether) the cost of SGR repeal should be paid for. Last week, the House passed an amended version of H.R. 4015 in a vote of 238 to 181. Through this legislation, the estimated $138 billion price tag of repeal would be paid for by delaying the Affordable Care Act's individual mandate for five years, an approach that is not acceptable to most Democrats. The Senate does not intend to take up the House bill and is expected to have a vote on its own package, based on S. 2000 and paid for through use of estimated savings from the drawdown of the war in Iraq/Afghanistan or with no budgetary offsets, next week. This approach is expected to garner little if any Republican support. While H.R. 4015/S. 2000 is still on the table, Congress may opt to patch the SGR again, as they've done more than a dozen times before, in order to avoid the detrimental payment cut that is set to kick in April 1.

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