Trump, Congress’ spending plan doesn’t help Medicare reimbursement for docs

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Doctors hoping for a financial reprieve in Congress’ continuing resolution were disappointed with the bill approved March 15.

President Donald J. Trump on March 15 signed the continuing resolution needed to avoid a federal government shutdown and continue government services through the end of September, according to news reports.

Conspicuously absent was financial help for physicians, in the form of money to counter the 2.83% cut in reimbursement to doctors in the 2025 Medicare Physician Fee Schedule.

That provision, or lack of it, prompted criticism from the Medical Group Management Association (MGMA), which blamed the 2015 Medicare Access and CHIP Reauthorization Act, known as MACRA. It included quality measures for physicians and patients, but the financial effects of the law have led to five consecutive years of declining physician pay, said the statement from Anders Gilberg, MGMA senior vice president of government affairs.

“The passage of the CR without a Medicare physician payment fix represents a massive congressional failure and blatant abdication of duty to our nation's physicians and their beneficiaries,” Gilberg said.

Congress must enact comprehensive physician payment reform — or, until then, at least protect the financial viability of medical practices by averting pay cuts, he said.

“To avoid this annual chaos, which increasingly threatens beneficiary access to care, Congress must realize permanent, sustainable solutions, such as implementing an annual, inflation-based physician payment update tied to the full Medicare Economic Index and modernizing Medicare's antiquated budget neutrality policies,” Gilberg said.

A potential solution

Legislators have a potential solution on paper. Last week, the Medicare Payment Advisory Commission (MedPAC) published its March 2025 report to Congress with the recommendation to change the formula for paying doctors.

Current payment to clinicians appear to be adequate, based on indicators including patient access to doctors, the MedPAC report said. Under the current law, 2026 payment rates are expected to rise by 0.75% for physicians and other clinicians in advanced alternative payment models and by 0.25% for all other clinicians, according to MedPAC.

However, “given recent high inflation, cost increases in 2026 — which currently are projected to be 2.3% — could be difficult for clinicians to absorb,” the MedPAC report said.

For calendar year 2026, Congress should replace the current law formula with a single update equal to the projected increase in the Medicare Economic Index minus 1%, according to MedPAC. Given current projections, that would mean a 1.3% increase for doctor pay next year.

In addition, Congress should approve a safety-net add-on policy of 1.7% more pay for physicians and other clinicians who treat fee-for-service Medicare beneficiaries with low incomes. Added to the projected 1.3% increase, that would mean an average 3% pay raise over the current law, according to MedPAC.

Actual reimbursement effects would vary based on provider specialty and number of low-income beneficiaries, but the news could get better for primary care: MedPAC estimated the combined raises would total an average of 5.7% for primary care clinicians and an average of 2.5% for other clinicians.

Doctors voice support

American Medical Association (AMA) President Bruce A. Scott, MD, said that organization supported MedPAC’s proposal.

While MedPAC has noted access to care appears adequate, Scott countered that “the status quo is not an option,” especially for smaller practices in rural and underserved communities.

“This recommended policy change is needed to ensure patients will have continued access to quality care,” Scott said in a statement published before the congressional vote.

“Medicare is broken,” he said. “Under the financial stress, burnout has become an occupational hazard for physicians. As these cuts pile up year after year, more and more physicians are closing their practices, leaving patients without access. It just makes sense that payment must keep pace with increasing costs. Other providers already have automatic, yearly updates, and physicians are the foundation of health care.”