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house Bill H.R. 2

The "Doc Fix": Reforming Medicare Reimbursements For Doctors and Reauthorizing Other Medical Programs

Argument in favor

This bill would strengthen Medicare by permanently repealing the Sustainable Growth Rate (SGR), it will save taxpayers money, and put the U.S. budget on a more sustainable path.

EricRevell's Opinion
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03/30/2015
Will this cost more between now and 2025? Yes, unfortunately. But doing nothing means doctors will get paid less, and our physician shortage will worsen. Plus, this bill should save money after 2025.
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Cary's Opinion
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04/07/2015
We should pay doctors the appropriate amount for their services.
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Stephen's Opinion
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03/28/2015
Must insure accountability and end the fraud
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Argument opposed

"Sustainable"? This bill wants to permanently repeal the SGR without meaningful spending reductions — adding $141 billion to federal deficits seems like the opposite of putting U.S. spending on a better path.

ark4162's Opinion
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03/28/2015
Its high time you quit spending my money. I am against anything that costs 1 penny more than it did last year. The answer is not more money. The answer is spend it smarter. Government pisses away too damn money on administration and stupid crap. Its time to audit and streamline everything, cut out all the stupid spending and stupid costly rules and regulations, (I bet my next paycheck if the gov ran like a business it could have all the entitlements it does now on half the money) and start running it like a business. You do not have permission to spend any more of my money until you prove you can be responsible with it I don't give a damn what party you claim to belong to!
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Cebrith's Opinion
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03/28/2015
Stop with the spending, already!!! In the private sector, we'd be in prison if we behaved like Washington...
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ThomasParker's Opinion
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05/23/2015
We need to get to government out of our healthcare completely.
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What is House Bill H.R. 2?

This bill would reform Medicare’s Sustainable Growth Rate (SGR), a formula used to determine physician reimbursement. The bill would extend the Children’s Health Insurance Program (CHIP) by two years, while implementing other changes to Medicare and related health programs.

The SGR was established in 1997 to set the Medicare payment rates for physicians. It was designed to ensure that the spending per beneficiary for physician services would "grow on average at the rate of increase in gross domestic product per capita minus the expected rate of increase in productivity for the economy as a whole." 

This bill would repeal the current SGR that is currently scheduled to reduce physician compensation by 21 percent on April 1, 2015. The SGR would be replaced with plan to give physicians a 0.5 percent annual pay increase through 2019. After that, doctors would operate in a system that either grants them bonuses or penalties based on their government performance scores.

Funding for CHIP would be extended until 2017, as it would currently run out of money after the 2015 fiscal year despite the program being authorized through 2019. If you don't know, CHIP is a program offering low-cost health coverage to children from families that earn too much money to qualify for Medicaid. It is offered in every state and as of 2013, covers more than eight million children and pregnant women.

This bill also authorizes another two years of funding into 2017 for the Community Health Center (CHC) Program, that is otherwise set to expire in September 2015. In 2013 the CHC served 22.7 million patients across 9,518 sites.

Impact

Patients enrolled in Medicare and/or CHIP, physicians providing services through Medicare and/or CHIP, the Department of Health and Human Services (HHS), the Secretary of HHS.

Cost of House Bill H.R. 2

$141.00 Billion
A CBO estimate found that enacting this bill would increase both direct spending (by about $145 billion) and revenues (by about $4 billion) — resulting in a $141 billion increase in federal budget deficits.

More Information

Of Note: Congress has been forced to pass 17 of these so-called “Doc Fix” bills in the last 11 years, with many ready for a long-term solution to be put in place. While this legislation does have bipartisan support in both chambers of Congress, it has been met with concerns from both sides of the aisle as well.

Some House Republicans are concerned that Speaker Boehner will be unable to rally a majority of his members to support the legislation, while Senate Democrats are said to favor a four-year extension of CHIP — which is longer than what this legislation currently offers. House Democratic whip Steny Hoyer (D-MD) noted that while he’d prefer a four-year extension of CHIP, “the issue is between zero and two [years]. And two is better than zero."


Other provisions of this bill: This bill would extend specific Medicare programs, including those for Medicare-dependent hospitals, Medicare Advantage plans for special needs individuals, and funding outreach regarding low-income programs - among others.

The qualifying individual (QI) program would be permanently extended — allowing it to assist low income individuals in covering the cost of their Medicare Part B premium. The transitional medical assistance (TMA) program — helping families covered by Medicaid to maintain their coverage for up to one year as they transition from welfare to work — would also be extended permanently.

Programs for Native Americans with Type I and Type II Diabetes would be extended through 2017. Also extended through 2017 would be abstinence only programs and the personal responsibility education program (PREP) which allows states, tribes, and other local agencies to implement strategies for youth development, adulthood preparation, and preventing teen pregnancy and STD transmission.

Beginning in 2020, new enrollees to Medicare's supplement insurance, Medigap would only receive first-dollar coverage (i.e. the plan pays both deductibles and copayments) after the amount of the Medicare Part B deductible (which is currently $147 per month).

Income-related premium adjustments for Parts B and D would increase the percentage that Medicare beneficiaries with incomes between $133,501 and $160,000 as individuals (or $267,001 - $320,000 as a couple) from 50 percent to 65 percent. Beneficiaries that have incomes at or above $160,001 or ($320,001 as a couple) would pay 80 percent of their premium. These thresholds would be updated based on inflation beginning in 2018.


Media:

Summary by Eric Revell 

(Photo Credit: Flickr user darkensiva)

AKA

Medicare Access and CHIP Reauthorization Act of 2015

Official Title

To amend title XVIII of the Social Security Act to repeal the Medicare sustainable growth rate and strengthen Medicare access by improving physician payments and making other improvements, to reauthorize the Children's Health Insurance Program, and for other purposes.

bill Progress


  • EnactedApril 16th, 2015
    The President signed this bill into law
  • The senate Passed April 15th, 2015
    Roll Call Vote 92 Yea / 8 Nay
  • The house Passed March 26th, 2015
    Roll Call Vote 392 Yea / 37 Nay
      house Committees
      Committee on Agriculture
      National Parks, Forests, and Public Lands
      Committee on the Budget
      Committee on Energy and Commerce
      Committee on Natural Resources
      Committee on the Judiciary
      Committee on Ways and Means
      Health
    IntroducedMarch 24th, 2015

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    Will this cost more between now and 2025? Yes, unfortunately. But doing nothing means doctors will get paid less, and our physician shortage will worsen. Plus, this bill should save money after 2025.
    Like (10)
    Follow
    Share
    Its high time you quit spending my money. I am against anything that costs 1 penny more than it did last year. The answer is not more money. The answer is spend it smarter. Government pisses away too damn money on administration and stupid crap. Its time to audit and streamline everything, cut out all the stupid spending and stupid costly rules and regulations, (I bet my next paycheck if the gov ran like a business it could have all the entitlements it does now on half the money) and start running it like a business. You do not have permission to spend any more of my money until you prove you can be responsible with it I don't give a damn what party you claim to belong to!
    Like (9)
    Follow
    Share
    Stop with the spending, already!!! In the private sector, we'd be in prison if we behaved like Washington...
    Like (6)
    Follow
    Share
    We need to get to government out of our healthcare completely.
    Like (5)
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    It will hurt the middle class and the underclass
    Like (5)
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    you have got to account for the sustainable growth rate. You can't just repeal it
    Like (4)
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    Must insure accountability and end the fraud
    Like (4)
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    We should pay doctors the appropriate amount for their services.
    Like (4)
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    Lack of health insurance should not not be either a death sentence or cause family bankruptcy.
    Like (3)
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    Should have been done years ago!!!
    Like (2)
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    We need real reform. Not these fake attempts.
    Like (2)
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    No brainer,but doctors who commit fraud should be delt with severly,no slaps on the hand.
    Like (1)
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    Republicans are always trying to take away health care for everyone but themselves
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    Why do government bureaucrats and politicians continually strive to eliminate healthcare options in this country by running physicians out of business? No physicians can make a living with Medicare reimbursements now. I am not talking about making $250,000-1,000,000 per year; I mean simply making a profit at all!
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    Why is the government in healthcare to begin with? Free markets, give the money back to the people who paid into the program.
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    I can't afford your 'fixes'
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    Tell me where the money is coming from, the IRS budget, Dept of Commerce, White House vacations. It is time to stop robbing the people to pay the government.
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    Disconnecting doctor's reimbursements from the economic index is not a wise thing to do. It would allow the cost of medical treatment to rise even if the economy plummets.
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    As the worlds super power we must do all we can to help those in need. We can protect and serve our fellow humans and punish those who are responsible.
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    no quit spending unnecessary money
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