Congress Steps Ahead on Doc Fix, Gambles with Critical Medicare Benefit

New York, NY—Yesterday, the Senate Finance Committee and House Committee on Ways & Means took critical steps forward to permanently repeal and replace the flawed Sustainable Growth Rate (SGR) formula used to annually adjust reimbursements to Medicare physicians.

“The payment policies adopted by the Senate and House Committees bring Medicare one step closer to embracing value as the foundation of patient care,” said Joe Baker, President of the Medicare Rights Center. “While this is good news for beneficiaries, the transition to a more rational payment system must not come at the expense of people with Medicare.”

The Senate package included extensions of policies that traditionally accompany an annual SGR patch, while the House has yet to take up these extenders. Among these is the Qualified Individual (QI) program, which provides premium assistance to Medicare beneficiaries with very low incomes and limited assets. Today, the QI benefit amounts to $104.90 per month in savings for eligible beneficiaries by covering the cost of the Part B premium. Raising significant cause for alarm, the Senate legislation did not make the QI program permanent, only extending the benefit through 2018.

Baker continued, “We are deeply disappointed that the Senate Finance Committee voted to gamble with the future of the QI program. Our helpline counselors assist thousands with enrolling in this vital benefit each year. We know the value of the QI program, because we know the difference that every dollar makes to beneficiaries living on meager incomes.”

Both chambers of Congress have yet to determine how to pay for a permanent SGR solution. Baker said, “Policies that shift higher health care costs to older adults and people with disabilities must not be considered as offsets to pay for an SGR package. Most people with Medicare simply cannot afford to pay more.”

Today, half of all people with Medicare—25 million older adults and people with disabilities—live on annual incomes of $22,500 or less. Baker concluded, “We sincerely hope that Congress will put the needs of our nation’s retirees and people with disabilities first and foremost as negotiations on a permanent SGR fix move ahead.”

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