House proposed budget would not restore Medicare reimbursement cuts to physicians

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Physicians panned a federal spending plan that freezes the 2025 reduction in reimbursement in this year’s Medicare Physician Fee Schedule.

The House of Representatives’ Appropriations Committee announced the bill March 8 with an expected floor vote this week.

The announcement about the legislation included takeaways relating to some health-related programs and issues. However, doctors’ organizations blasted the legislation for what it didn’t contain — a financial provision to cover the 2.83% cut to physician reimbursement in the Medicare Physician Fee Schedule.

From a House leader

Committee Chair Rep. Tom Cole (R-Oklahoma) introduced the spending plan and threw down the gauntlet for Democrats to challenge it and the intentions of President Donald J. Trump.

"Funding the federal government is a constitutional obligation, and House Republicans are acting to uphold that duty,” Cole said in the announcement. “This straightforward continuing resolution ensures the government remains open and working for Americans. It maintains critical services for our constituents and provides the largest pay raise for our brave junior enlisted heroes since President Reagan. With no poison pills or unrelated riders — the bill is simple: extend funding and certainty for the nation.

“Democrats have a choice to join us or display their true intentions,” he said. “Should they choose to vote to shut the government for negotiation leverage and their contempt of President Trump, they are readying to hurt hundreds of millions more. It’s a battle they lost in November, and one the people will continue to see through. Our good-faith efforts provide an immediate solution to the deadline before us.”

Health-related programs

The House Appropriations Committee announcement included key takeaways, including some related to health care, public health and social welfare programs. For example, it “protects Social Security, Medicare, and Medicaid recipients from the disruptions and confusion a shutdown will cause.”

The bill also has a $500 million increase for the Special Supplemental Nutrition Program for Women, Infants, and Children, known as WIC.

‘Physicians are outraged’

American Medical Association President Bruce A. Scott, MD, issued a statement that repeated doctors’ claims that continuing reimbursement cuts ultimately will jeopardize patient access. Physicians may stop taking Medicare patients — or simply close their doors because their practices cannot make ends meet.

“Physicians across the country are outraged that Congress’s proposed spending package locks in a devastating fifth consecutive year of Medicare cuts, threatening access to care for 66 million Medicare patients,” Scott said. “Despite repeated warnings, lawmakers are once again ignoring the dire consequences of these cuts and their impact both on patients and the private practices struggling to keep their doors open.”
The budget will be “particularly devastating for rural and underserved communities,” Scott’s statement said.

“These physicians and their patients have borne the brunt of the rising practice costs – 3.5 percent this year according to Medicare’s own estimate,” he said.

The cuts are nothing new. When adjusted for inflation, Medicare payment to doctors has dropped by 33% since 2001, a calculation AMA has repeated for several years.

“Let me be clear: These unsustainable cuts will force more practices to close and leave patients with fewer options for care,” Scott said. “Congress has failed physicians, and Medicare patients will pay the price. The window to reverse this reckless decision is rapidly closing. Lawmakers must explain either why protecting access to quality health care is not a priority or how they plan to fix it.”

Where’s the support?

The budget does not have to be this way, because there was huge bipartisan support for HR 879, the Medicare Patient Access and Practice Stabilization Act, Medical Society of the State of New York President Jerome Cohen, MD, said in a statement. Doctors were “stunned” that lawmakers will allow the physician payment cut to remain in effect, not least when the House GOP Doctors Caucus supported stopping this year’s cuts to Medicare reimbursement, Cohen said.

He also noted the continuing decline in physician reimbursement since 2001.

“This is simply not sustainable and is a major reason why so many community-based physician practices have been unable to remain afloat to deliver care to their patients,” Cohen said. “Exacerbating the latest cuts is the looming threat of devastating Medicaid cuts based upon the recently enacted Congressional blueprint, at a time when patients covered by Medicare and Medicaid make up an overwhelming number of our community physicians’ patient population.”

Cohen specifically urged New York’s delegation to Congress, including the majority members, to stop any cuts that threaten patient access to community-based physician care. That includes any cuts to Medicare and Medicaid in upcoming continuing resolution and reconciliation bills.

“Your constituents and our patients are depending upon it,” he said.