AGS Board of Directors Expresses “Strong Support” for Healthcare Reform

AGS Board of Directors Expresses “Strong Support” for Healthcare Reform in Letter to President as Democratic Leaders in Congress

The AGS’s Board of Directors expressed its strong support for the enactment of healthcare reform in a letter sent to President Barack Obama in mid-March, just as this issue of Annals of Long-Term Care was going to press. The letter reached the President’s desk as Democratic leaders in Congress began pressing for final votes on reform legislation before month’s end.

In its March 12 letter to President Obama, the AGS Board notes that “numerous provisions in the reform legislation now before Congress will lead to far‐reaching and lasting improvements in the quality of care provided to older Americans, and will help ensure the sustainability of Medicare.

“As an organization we have had the opportunity to provide extensive comments and feedback on health reform to Congress and to your Administration,” the letter continues. “As a result, the legislation under consideration in the Capitol will bring about much needed policy changes that, we are convinced, will result in better coordinated, higher quality and more affordable care for older adults. This legislation will also enhance geriatrics education and training and expand the capacity of the nation’s healthcare workforce so it can provide high quality, efficient and affordable care that meets the unique needs of seniors nationwide.”

While Democratic leaders were optimistic midmonth—vowing to pass, as early as the third week of March, two measures that must be approved if healthcare reform is to take effect—uncertainties remained.

One of the bills, the so-called “reconciliation bill” drafted by Democratic leaders in both chambers, would amend the Senate plan to address House concerns about certain elements of the Senate legislation. By using reconciliation, Democrats can prevent Republicans from blocking health reform by filibustering.

As of mid-March, however, obstacles remained, including differences among Democrats over the wording of abortion restrictions in the legislation. Rank-and-file Democratic lawmakers were asking the leadership for more detailed information about the reconciliation bill, and telling reporters that without this information it would be difficult for them to decide how to vote. In addition, leaders and rank-and-file lawmakers alike were still awaiting a new Congressional Budget Office (CBO) assessment of the proposed legislation, without which they cannot move forward.

An earlier CBO report concluded that the Senate bill would cover 31 million uninsured Americans over the next ten years at a cost of $875 billion. According to the CBO, this would be more than offset by new taxes and fees and reductions in Medicare spending—the President has vowed that these will result from stepped-up efforts to eliminate widespread fraud and waste in the program—and trim budget deficits by $118 billion over the ten-year period.

“Like you, we are convinced that healthcare reform must move forward so that we, as a nation, can begin to address the long‐term viability of the Medicare program,” the AGS Board writes in its letter to the President. “Soaring health costs, in combination with the wave of Baby Boomers reaching retirement age, are placing the sustainability of the program in jeopardy; waiting to address these challenges is a risk our nation cannot afford to take. Increased costs that are passed along to Medicare beneficiaries are already challenging for older Americans on fixed incomes. Provisions included in both the House‐passed Affordable Health Care for America Act and the Senate‐passed Patient Protection and Affordable Care Act will help Medicare beneficiaries by improving benefits, expanding access to primary and preventive care, decreasing the rate of premium increases, and extending the solvency of the Medicare Trust Fund by five or more years.”

AGS Continues to Call for Fix for SGR After 21% Cut in Medicare Pay to Physicians Takes Effect Briefly

Less than two weeks after it voted on March 2 to both reverse a 21% cut in Medicare payments to physicians that was triggered by Medicare's problematic Sustainable Growth Rate (SGR) formula, and to defer the cut until April 1, Congress was reportedly at work on a longer-term fix for the problem.

The 21% cut took effect March 1, after the Senate failed to follow the House in voting to postpone the cut until April 1. The cut was originally to have taken effect January 1, but both chambers had voted in late December to postpone it until March 1.

The AGS applauds Congress for further postponing the draconian cut, which threatened older adults' access to healthcare. And it continues to urge lawmakers to find a permanent alternative to the flawed SGR formula, which has mandated physician pay reductions each year for the last several years. Only last-minute action by Congress has prevented these devastating cuts.

Following the Senate's initial failure to block the cut, the Centers for Medicare & Medicaid Services (CMS) ordered Medicare contractors to hold, for ten days, claims for services provided on and after March 1, to obviate refilling should Congress address the issue within that time frame. The day after the Senate’s March 2 vote, CMS announced that it had lifted the hold.

In both the House and the Senate, legislative proposals for longer, albeit still temporary, fixes that would postpone physician pay cuts for 90 days, seven months, or through the end of 2010, are being circulated.