Tuesday, March 18, 2014

SGR Funding Battle Continues

Drew Thies

The policy agreement to repeal and replace the Sustainable Growth Rate (SGR) continues to be plagued by distinctly partisan funding battles.

Last Friday, the House voted 238-181 for a version of the legislation that would fund a permanent replacement of the SGR with a delay of the Affordable Care Act’s (ACA) mandate that individuals purchase insurance. Twelve Democrats voted in favor of the legislation.

The Senate is not expected to take up the proposal, given Senate Majority Leader Harry Reid’s (D-NV) reticence to not touch any legislation that affects the President’s landmark healthcare law. The White House released an advance statement on Wednesday noting that President Obama would veto any proposal that uses the ACA to fund another program.

Meanwhile, Leader Reid told Speaker John Boehner (R-OH) that he wants to use Overseas Contingency Operations (OCO) funding to pay for another “doc-fix” that would patch physicians’ Medicare for another nine months.

Use of the OCO funds—unspent money resulting from drawing down the wars in Iraq and Afghanistan—is expected to receive pushback from the GOP if included. The Congressional Budget Office (CBO) wrote in a letter to House Budget Committee Chairman Paul Ryan (R-WI) that the funds are considered discretionary and therefore cannot be used to offset direct spending, such as Medicare.

Rep. Phil Gingrey, member of the House Ways & Means Committee and co-chair of the GOP Doctors Caucus said he’d “have an almost impossible time” voting for legislation that uses OCO funding.

Members of Congress on both sides of the aisle have started to fear that the funding battles will derail the bipartisan, bicameral policy intended to replace the SGR and will instead result in yet another patch.

Congressional health staff will certainly be busy this week searching for funding solutions. Both chambers are in recess until Monday, March 24th, and the current doc fix is set expire on March 31st. This leaves Congress with only five legislative days to prevent a 24% cut in doctors’ Medicare reimbursement.

The AHCA legislative team continues to monitor the situation and advocate on behalf of skilled nursing and assisted living as the deadline for funding decisions draws near.

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