Real Entitlement Reform With The Doc Fix Repeal

By Grace-Marie Turner

It is long past the time for Congress to recognize and rectify a failed policy.

An earlier Congress, led by former speaker Newt Gingrich, decided to cut payments to physicians in Medicare to help balance the federal budget. That was in 1997, but even that Congress postponed the cuts until a future date. And because access to physicians would be jeopardized for millions of seniors if the cuts took effect, every Congress since then has postponed the Medicare cuts – a total of 17 times.

The policy didn’t work, and Congress now is ready to consider permanently repealing it while bringing much-needed structural reforms to Medicare. That is the right course. Republicans and Democrats from both houses of Congress have been working on the deal for months, with cooperation from the administration. For those who want to move beyond what they consider a “broken” Congress, this is the place to start.

The current doc-fix extension expires on March 31 when physician reimbursement will be cut by 20% if Congress doesn’t enact yet another patch. It’s clear that #18 is not going to be a magic number.

Virtually no one believes that Congress ever will allow the cuts to take effect, especially because they get bigger and bigger over time. Even Medicare’s Board of Trustees builds the expected fix into its baseline projections, assuming Congress will continue to override the annual “Sustainable Growth Rate” (SGR) cuts to the Medicare physician fee schedule.

Conservatives are criticizing the deal because it is not fully paid for in the 10-year budget window, but the structural Medicare reforms built in to the deal would yield much larger savings over time. This is an investment today to begin to gain control over a program that by the year 2020 will constitute more than one-third of the nation’s total debt accumulation.

Continuing to play the Medicare doc fix shell game only makes it harder to get control of federal spending, and it keeps Congress from focusing on real and desperately-needed entitlement reform.

Originally published on Forbes, March 17, 2015

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