The ACP Advocate Blog
by Bob Doherty
Thursday, March 18, 2010
It's a wrap
Today, the House leadership released the final "corrections" bill that will modify provisions in the legislation passed by the Senate on December 24, putting it on track to be voted on by the House on Sunday. Politico has a good summary of key changes made by the legislation. Earlier in the day, the Congressional Budget Office released its "score" of the legislation. And President Obama postponed his planned trip to Indonesia and Australia to be present through the voting on the bill.
The CBO report should help innoculate the bill from the charges that it is fiscally irresponsible. Instead, CBO concludes that it will lower the deficit by $130 billion over the next ten years and by more than a trillion dollars over 20 years while covering 32 million more Americans - 95% of all legal residents. And, the CBO shows that the vast majority of Americans - more than 162 million of us - will continue to get coverage from private, employer-based health insurance, not a government-run plan.
What about the charge that the package will harm the Medicare program? Actually, as the House leadership has also pointed out, the Medicare savings in the bill (which are mainly reductions in the rate of increase in payments to hospitals and other non-physician providers - which in the case of the hospitals, was negotiated with their approval) will extend the life of the Medicare Part A trust fund by seven years. That's right - seven more years before Medicare goes broke if this bill is passed than if it isn't.
The final package has an important improvement from the Senate bill that ACP championed. Medicaid payments for all evaluation and management services by primary care physicians in 2013 and 2014 will be increased to no less than the Medicare rates. ACP will work to make this a permanent change so it doesn't expire after 2014. But this change, combined with the 10% Medicare bonus for office and outpatient visits by primary care internists and other primary care clinicians, are important first steps toward addressing long-standing payment disparities.
I'll have more to say about the legislation in tomorrow's blog, but the bottom line is that the changes made from the Senate bill, and the CBO report, confirm ACP's view that the legislation will advance key priorities on coverage, workforce, and payment and delivery system reforms, while reducing the deficit and helping to keep Medicare afloat.
Oh, and as always, I invite your reaction and comments on today's blog and the latest news, but let's try to keep the dialogue free of name-calling or attacks on the integrity and motivations of those you disagree with. Today, I reluctantly allowed a comment to be posted that disparaged those of you who regularly post comments on this blog, which I don't think really helped the argument of the person making the comment. I know that emotions are running strong, and passionate responses can be expected, but can't we all at least try to be respectful of those we disagree with, and assume that they too are motivated by doing what they think is right, even if you or I disagree with them?
Today's question: What is your reaction to the final legislation and the CBO report?
About the Author
Bob Doherty is Senior Vice President, American College of Physicians Government Affairs and Public Policy; Author of the ACP Advocate Blog
Email Bob Doherty: TheACPAdvocateblog@acponline.org.Follow @BobDohertyACP
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