Physicians are calling on Congress to cancel a cut in reimbursements from Medicare scheduled for January 1.
In a nearly annual ritual, doctors’ groups argue that if lawmakers authorize salary cuts, patients will have a harder time finding doctors who accept Medicare.
It remains to be seen whether the doctors’ efforts to stem the cuts will succeed, as they have in the past few years.
Their lobbying efforts have attracted attention in the Capitol. A bipartisan group of 115 congressmen rallied last week in support of doctors in a letter to congressional leaders and President Joe Biden, saying they “just make a bad situation worse” for Medicare patients. urged to prevent the cuts they claim.
However, it is unclear if Congress will put pay cuts on hold or if such measures will be passed before the cuts take effect next year. If Congress moderates or avoids the planned cuts, measures to do so will be added to the annual government spending package, currently in last-minute negotiations on Capitol Hill. With the deadline less than two weeks away, Congress had not made clear whether it would act to stop them.
In recent years, the Centers for Medicare & Medicaid Services has slated pay cuts to offset the cost of increased payments for low-wage services such as primary care. We are witnessing reductions associated with the broad cuts we have made in the decade.
Some Republicans have urged waiting for the spending package to pass until their party can take control of the House next year and have a greater say in what they call out-of-control spending. One of the priorities of the incoming House Republican majority is, among other things, to curb Social Security and Medicare, the federal health insurance programs for people 65 and older.
“We’re mortgaging our children’s future,” Wisconsin Senator Ron Johnson, a Republican on the Senate Budget Committee, told reporters, referring to the overall spending. “This is killing us from a financial standpoint. It has to stop.”
Despite fears of a surge in government spending, doctors have for years been successful in delaying or easing proposed salary cuts, arguing the consequences would be disastrous if cuts began. doing.
Doctors have a lot of political clout in Washington. The American Medical Association, a professional lobbying organization representing doctors, has spent more than $460 million on lobbying since 1998, more than any other organization, The New Yorker said. magazine reported this year.
Since the early 2000s, Congress has voted annually or twice to postpone or reverse plans to cut Medicare payments to doctors. In 2015 Congress dropped his one bill that cut payments by 21%. Congress closed her 3% hole last year.
On January 1st, doctors will face a 4.5% cut in Medicare fees. Other cuts include a 4% cut under the Congressional Budget Rule to balance spending and the termination of a payment program that provided a 5% bonus.
As ever, doctors are desperate to convince Congress that cutting the amount that Medicare patients are paid for care will keep more doctors away from accepting them as patients. I have run a campaign.
Earlier this month, the American Medical Association sent a letter to congressional leaders signed by the 50 state medical associations and the District of Columbia medical association, arguing that pay cuts would hurt doctors and patients.
“One in five doctors are considering leaving their current practice within two years due to burnout, stress, workload and the cumulative impact of COVID-19,” the letter said. . “Reductions in payments will only accelerate this unsustainable trend and will undoubtedly cause Medicare patients to struggle to access health care services.”
According to the American Medical Association, operating costs for medical practices rose 39% from 2001 to 2021, but inflation-adjusted Medicare payments to doctors fell 20% during that time.
Citing rising costs, from gauze and surgical tubes to salaries for office staff, Dr. Loralie Ma, a radiologist in suburban Baltimore, said, “Running our business is more expensive than it used to be. It takes time,” he said. “It’s very difficult. When Medicare does something like this, it reduces access, especially for older people.”
“We have patients looking for doctors who can’t find them. They’re on Medicare, and doctors aren’t accepting new Medicare patients,” said a Santa Cruz, Calif.-based physician and member of the California Medical Association. President Dr. Donald Hernandez said.
He said it would be difficult to “balance” Medicare patient care at current government rates. “It doesn’t make sense economically.”
The agency that advises Congress on Medicare issues has expressed concern about certain Medicare payments for primary care, stating that from 2015 to 2020, the number of primary care physicians treating Medicare beneficiaries will exceed 1,000 beneficiaries. reported a decrease from 2.8 to 2.4 per person.
According to the Medicare Payments Advisory Panel (MedPAC), about 3% of Medicare beneficiaries surveyed in 2021 said they had looked for a new primary care provider in the previous year and had trouble finding one.
However, looking at the big picture, based on data from 2019 to 2021, “Medicare beneficiaries’ access to clinician services remains stable and is comparable (or better) than privately insured individuals. It also looked good,” MedPAC Chair Michael Chernew said on Oct. 28. Letter to members of parliament.
Gerald Anderson, a professor of health policy and management at Johns Hopkins University, said doctors’ opposition to the planned pay cuts is well known.
“For 40 years, I’ve heard health care providers claim that if cuts were made, they would either go out of business or not accept Medicare patients,” Anderson said. “Medicare patients are still seeing doctors, hospitals and other health care providers 40 years later.”
For most doctors, medical reimbursement payments from Medicare are only a small part of their business, Anderson added. He said it could include payments from insurance companies.
Senator Debbie Stabenow of Michigan, the top Democrat in the Senate, and John Barrasso of Wyoming, the top Republican in the Senate, were signed in November by a bipartisan group of 44 other senators. wrote a letter urging party leaders to block the imminent cuts.
“We very much want a health package that stops the cuts and makes other policy changes that are needed.
When asked if she was optimistic, she said, “I think there’s a reasonable chance.”
KHN Washington editor and correspondent David Hilzenrath contributed to this report.
