Fort Worth Star-Telegram

April 3, 2015

At town-hall meetings and events across greater Fort Worth, seniors ask me repeatedly why they had to change doctors when they enrolled in Medicare. Doctors and care providers tell me that they simply cannot afford to continue caring for Medicare patients because they are threatened with reimbursements that fall short of service costs.

Simply put, The Sustainable Growth Rate formula (SGR) is the top culprit. 

I’ve been trying to repeal it ever since I came to Congress because – as a physician – I know first-hand how destructive this formula is to the doctor-patient relationship.

For background, SGR was approved by Congress in 1997 as an attempt to mitigate growing Medicare services. But, the formula proved uneven to the growth of the medical industry, highly unrealistic, and ultimately threatening to care providers’ ability to serve patients. 

Since 2003, Congress has continued scrapping together “patches” to soften this blow. This method creates never-ending uncertainty for providers and constantly threatens seniors’ access to care. These patches are a failed price control, a failed budget gimmick that hide the true cost of Medicare costs to the taxpayer, and will only get more expensive. 

This path is unsustainable.

But, there’s new hope.  After wasting time and taxpayer dollars re-hashing this issue 18 times since 2003, Congress is closer than ever to a permanent solution.

In a rare show of unity last week, the House of Representatives passed this legislation, ”The Medicare Access and CHIP Reauthorization Act,” to repeal the Sustainable Growth Rate and preserve the integrity of our Medicare system with an astounding 392 votes.

For elderly beneficiaries
This bill is all about access for seniors and the end of the annual threat to their care. Once SGR is repealed, the new system will streamline Medicare’s existing web of quality programs into a single framework. This will drastically improve payment accuracy and encourage physicians to adopt proven practices. Therefore, creating a more transparent system where doctors –not bureaucrats – are in charge.  

For doctors and other licensed care providers
Most importantly, my bill will finally stop the uncertainty of dramatic payment cuts. It enacts a 0.5 percent payment update for five years – bringing stability and longer term financial certainty to practices. 

Additionally, it includes provisions to incentivize the use of alternative payment models that encourage focus on coordination among providers and preventative services that improve quality and lower cost. 

For taxpayers
This bill points us back toward fiscal sanity, and is the first major entitlement reform in nearly 20 years. 
The non-partisan Congressional Budget office announced that this legislation will likely result in a net savings, because the cost of freezing Medicare’s payment rates would cost much more than this fix – to the tune of about one billion dollars.

The Senate must act now
For Washington, this is the first step toward real entitlement reforms in decades and ends years of irresponsible policies. For the elderly, it means a stronger overall Medicare system and, for taxpayers, it means honest accounting, real savings, and brings us closer to fiscal solvency.

If the Senate doesn’t act on this legislation when they reconvene in just less than two weeks, it means another year of instability for seniors and providers. Because the last patch expired on April 1, an automatic 21 percent pay cut for providers was triggered, which must now be fixed regardless. 

We’re closer than ever to putting this issue behind us and focusing on future reforms and I am proud to have done my part in this fight. But, this must be done, and I won’t stop working on this for seniors and providers until it is law.