Congress Does the Impossible

Mar 27, 2015
EC from DC

This week, I received call after call on a certain bill coming before the House for a vote. Some callers asked me to vote for the bill. Some callers asked with me to vote against it. To those doctors, nurses, and senior citizens who took the time to call me and my staff, I appreciate hearing your thoughts, and I do value your messages. To the hospital officials and health center advisors who came in to meet with me, thank you for your time and your insights. At times like these, I know it is important to listen to all sides and sentiments on an issue before making a decision.

My decision, ultimately, was to vote yes. Yes on a bill that will help seniors, doctors, hospitals, health centers, and children in need. Yes to solve a problem that has plagued us perennially.

The bill was H.R. 2, the Medicare Access and CHIP Reauthorization Act of 2015. It replaces the SGR, or Sustainable Growth Rate formula. What is SGR? It’s the way the government tallies up how much to pay doctors who treat patients with Medicare. The Sustainable Growth Rate was poorly named, because in truth it was the opposite of sustainable. For the first few years, it worked well enough.

Soon it was clear that SGR was broken. If Congress did not act, then doctors wouldn’t be paid fairly. That would undermine Medicare. That would endanger care for seniors. Every year, Congress would throw its hands up in the air and put a patch on the perennial problem, passing another “doc fix.” Imagine if you tried that at your job, or if your child did it at school! Seventeen times, over the past twelve years, we have kicked the can down the road. Medicare deserves more than a band-aid fix, but that is all Congress was giving. No more.

This bill puts those problems behind us. This bill takes the old, broken formula, and replaces it with a new formula that will reward value, ensure the proper payments to doctors, and improve the quality of care for patients.

 



This bill is an example of true bipartisanship and good governance—so rare these days. Both Democrats and Republicans came together to pass this bill overwhelmingly, by a vote of 392-37. And if you can believe it, I agreed with words that Speaker John Boehner spoke yesterday about this very bill:

“Today, the House will pass legislation that’ll make real progress in strengthening Medicare. This is a bill that will provide better health care for seniors and real savings for taxpayers. The bill will permanently replace the so-called ‘doc fix’ budget gimmick with a system that’s more stable that rewards quality and innovation in the delivery of our health care. It will help ensure that seniors have access to their doctor, and put in place a stronger Medicare program to aid every American who are trying to care for their elderly parents.”



I am not afraid to say it: Speaker Boehner was right. And the bill includes other ways to help our public health and well-being.



This bill extends the Children’s Health Insurance Program (CHIP) for two years. CHIP helps 93,000 children in Missouri afford medical care.



The bill extends funding for Community Health Centers by $7.2 billion for two years. There are three community health centers in Missouri’s Fifth District: Health Care Coalition of Lafayette County, Samuel U. Rodgers Health Center, and Swope Health Services. At their thirteen locations in our community, these health centers serve over 60,000 underserved patients and communities.

There are also bipartisan provisions to strengthen Medicare’s ability to fight waste, fraud, and abuse, and to build on existing program integrity policies. There are funds that will help rural hospitals serve their patients. There are funds to help increase the number of primary care doctors and dentists in communities that need them. There are funds for outreach programs to provide help and guidance to new mothers, and to families with children who have special health-care needs.

You may say, this is all well and good, but how is it all paid for? Are we raising the cost of Medicare? The bill was paid for with savings from providers and from beneficiaries. Ninety-eight percent of beneficiaries are unaffected. The vast majority of the savings from beneficiaries come from the very top two percent of Medicare enrollees, beginning in 2018. The only retirees affected by the provision are single people who make more than $133,500 a year, and couples who make more than $267,000 a year. The rest of the savings from beneficiaries comes from a modest Medigap reform. Believe it or not, as a result, the Medigap premiums will actually be lower!

Ultimately, this bill was the right way to solve a really tough problem. This will help our seniors and children in need, the doctors who treat them, the hospitals and health centers where they get their care, and children around the country.