Congress Set to Begin Medicare Payment Tug-of-War

The end of this week could bring either a long-term delay of Medicare reimbursement cuts for physicians nationwide, either through true compromise or perhaps forced concession.

Reports today, including from Politico, indicate that bipartisan leaders in the Senate have agreed on a proposal to delay Medicare reimbursement payment cuts to physicians under the sustainable growth rate (SGR) formula for a period of one year. To foot the bill for the proposed $19.2 billion, 12-month postponement until 2012, Politico reports that the compromise deal would require individuals to repay federal subsidies they receive to acquire health insurance if their economic situation changes.

The Senate deal is by no means complete, requiring full approval in the Senate before heading over the House. Let's also keep in mind that the White House is mending some fences with Democrats in the Senate over its new tax cut deal.

But the one-year delay is being pushed by Democrats, with the backing of groups like the American Medical Association, to not only truly find a solution to constantly postponing looming cuts to doctors - resulting in practices constantly reevaluating their Medicare participation - but to also decrease the likelihood of being forced into a long-term deal otherwise.

How, you might ask? Well it all comes back to healthcare reform.

Politico and other outlets are quick to point out that some Republicans in Congress are fine with letting the Medicare cuts come right to the edge again, stirring the furor of physicians nationwide, only to fund a solution by pulling money from President Obama's healthcare reform law.
This is a similar tactic we saw with the tax cuts, where Republicans threatened to stand still as millions of Americans lost unemployment benefits. But the White House decided to extend all the Bush-era tax cuts in return for 13 months of benefits instead.

Seeing as President Obama and his staff are working hard to appease angry Democrats today, what's to say they won't agree on a similar deal to postpone Medicare cuts? A little money could come out of healthcare reform, especially if it keeps physicians seeing their senior patients. Isn't that the goal of healthcare reform after all: Keeping the doctor you like.

So stay tuned. This could be an interesting week in Washington, D.C. You could see a 12-month delay to work out a better Medicare payment plan and you might even see some parts of the healthcare reform plan lose funding. For some, that's a win-win situation.