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Today, March 26, the House of Representatives passed the Medicare Access and CHIP Reauthorization Act of 2015 (H.R. 2).  While the Center for Medicare Advocacy believes it’s in the best interest of Medicare beneficiaries to find a permanent solution to the broken physician payment formula called the “Sustainable Growth Rate” (SGR), this Bill is not the answer. Unfortunately, the SGR replacement package passed by the House is not sufficiently balanced; it asks too much from beneficiaries without providing enough in return. It asks nothing from pharmaceutical or insurance companies.  It furthers Medicare’s march toward privatization by increasing costs for beneficiaries for traditional Medicare and Medigap plans.

Of the portion of the SGR package that will be offset, roughly half (approximately $35 billion of the total $70 billion over 10 years) would come from Medicare beneficiaries through changes that will increase their out-of-pocket costs for health care, including:

  • Adding deductibles to Medigap plans purchased by new Medicare beneficiaries starting in 2020;
  • Further means-testing premiums for higher-income beneficiaries; and
  • Overall increases in Part B premiums.

While the SGR package would make the Qualified Individual (QI) program permanent, which we strongly support, and would minimally increase and temporarily extend important funding for low-income education and outreach, it does not address other issues that serve as barriers to care for beneficiaries.  For example, instead of repealing the annual outpatient therapy caps, the anemic exceptions process is merely extended for another two years, and instead of addressing hospital observation status, the bill simply further extends enforcement of the so-called “two-midnight” rule.

In short, Medicare beneficiaries would pay too much, with too little in return.  Major industries pay nothing, and stand to gain a great deal. As the SGR bill now moves to the Senate, we hope further balance and improvements for beneficiaries can be made.   

For more information, see the Center’s March 24th Press Release here:

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