CMS Administrator Donald Berwick, MD, and CMS Chief Actuary Richard Foster testified before the House Ways and Means Committee last week at a hearing titled, “The Impact of the Affordable Care Act on the Medicare Program and Medicare Beneficiaries.” We were there.

In the fall, Dr. Berwick testified before the Senate Finance Committee but this was his first time in front of a House committee. After discussing his background in medicine and what he views to be the many the benefits of the Affordable Care Act (ACA), Dr. Berwick held his own during tough questioning. This was also a ‘sniff him over’ process, given he has been promoted for confirmation again.

In his opening statement, Chairman Dave Camp (R-MI) noted the contrast between Dr. Berwick’s optimism on the ACA and Mr. Foster’s bleak outlook for Medicare due to the ACA. Foster has disagreed with others and the Congressional Budget Office on ACA savings, which Foster thinks are unlikely to be achieved. Democrats used the hearing to try to “shatter the myths about reform,” as stated by Ranking Member Sander Levin (D-MI) during his opening statement. Democrats repeatedly pointed to what they view as the most popular provisions of the law and what would happen if the law was repealed. In other words, this was a genuine partisan circus event.

There were plenty of controversial questions and answers. On tort reform, Dr. Berwick said he supports “exploring a national solution” on medical liability but would not comment on non-economic caps. Rep. Vern Buchanan (R-FL) told Dr. Berwick about a letter he wrote to CMS regarding concerns of Florida cardiologists with Medicare payment cuts for cardiology services (this "2010 Rule" issue preceded Berwick’s coming to CMS, but he’s sure hearing about it). When  Rep. Sam Johnson (R-TX) described physicians no longer participating in Medicare and having to reduce staff, benefits and charity care, Dr. Berwick stated that enrollment in Medicare is the highest ever for physicians. Poor Dr. Berwick -- he wants to talk about improving quality and patient safety and lowering costs in those ways, but there was no chance of that. Too bad he couldn’t just speak his mind, though. He had a lot of constructive non-partisan things he could have shared there, but that wasn’t what this hearing was about.

What did we and the nation learn from this hearing that we don’t already know? Nothing.

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