November 12, 2014

TO: Members of the California Congressional Delegation

The California Medical Association urges Congress to find appropriate budget offsets and pass H.R. 4015/S. 2000 the SGR Repeal and Medicare Provider Payment Modernization Act of 2014 during the Lame Duck Session.

Why?

It will Improve Access to Care

  • 5 million California Seniors and 1 million Military Families are losing their doctors because of a broken Medicare system and low Medicare payment rates.
  • Physicians desperately need stability and payment that incentivizes quality and value.

HR 4015/S 2000 has Bipartisan, Bicameral Support – Congress Must Seize the Momentum

  • Three House & Senate Committees have approved bipartisan, bicameral legislation to repeal the SGR and replace it with an alternative payment system.
  • Momentum will be lost next year with a new Congress and different Committee leaders.

It’s Fiscally Irresponsible Not to Fix Medicare Now

  • The cost to repeal the Medicare SGR is at an all-time historical low - $116 billion.
  • The cost of the 17 previous, short-term patches now exceeds the total cost of the permanent fix.
  • Another patch in 2015 will cost $50 billion–more than 1/3 the cost of the permanent fix.

EVEN CONSERVATIVE THINKERS ARGUE THAT THE SCORE TO REPEAL THE SGR SHOULD BE $0

Americans for Tax Reform – Ryan EllisQuotes – September 11, 2014(See Attached)

“Under a reality-based baseline, or what CBO might call an alternative fiscal scenario closer to reality, the actual score of repealing the SGR should be $0. That’s because SGR has never really been put in place, Congress has delayed it consistently, and it never will be put in place again. So getting rid of it is simply not a budgetary event. In fact, we know that roughly a decade of patches have “cost” more than simply repealing it is projected to cost now. The question is merely whether you want to do this once a year, or do it once and for all.”

“There’s ….a case to be made that SGR needs to go, and as soon as possible.”

Wall Street Journal – Review and Outlook Quotes – February 18, 2014 (See Attached)

“…health-care leaders in both parties are trying to repeal the phony Medicare payment scheme that has abetted a decade of budget dishonesty. What a pity other precincts in both parties are conspiring to defeat this political miracle.”

“Here’s a suggestion: Simply pass the bill as is and forgo the pretense of fake-paying for it…”

“(Some) are deluding themselves and fooling voters if they think retaining the SGR status quo is fiscal responsibility.”

Moreover, since 2010, Medicare has spent $590 billion less than CBO projected. Whether it is due to health care delivery changes or the recession, there is a substantial savings in the Medicare budget. These savings can easily cover the phony “cost” to repeal the SGR and replace the physician payment system.

CMA urges Congress to act during the Lame Duck Session. Historic progress has been made. If this issue is carried over into next year, we will lose the momentum and face the 18th patch in a decade. It is the most fiscally responsible way to keep doctors in the Medicare program, restore access to care, reform the payment system and restore physician trust in Congress.

Sincerely,

Luther F. Cobb, MD

President

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