HARTFORD – Today, U.S. Senator Chris Murphy (D-Conn.), a member of the U.S. Senate Health, Education, Labor, and Pensions Committee, celebrated the recent enactment of the “permanent doc fix” – a major, bipartisan legislative achievement that repeals the Medicare Sustainable Growth Rate (SGR) for physician reimbursement under Medicare and extends funding for the Children’s Health Insurance Program (CHIP) and community health centers nationwide. During an event with representatives from the CT Voices for Children, the Connecticut State Medical Society, the Connecticut Association of Community Health Centers, as well as medical professionals and other advocates, Murphy highlighted the importance of the SGR repeal to ensuring that physicians continue to provide care to Connecticut’s seniors and Medicare beneficiaries who were previously at risk of losing the ability to receive care from their doctor of choice. Murphy also emphasized the critical role that the repeal of this law will play in advancing medical research, patient care, and safety.
Murphy has strongly supported the decade-long effort to pass these provisions into law. Over the last 12 years, the SGR has created anxiety about potential cuts to physician reimbursement, but on April 16, 2015, President Obama signed the Medicare Access and CHIP Reauthorization Act into law. The legislation staved off a 21% cut in payments to doctors, and ended years of instability for physicians who care for seniors and Medicare beneficiaries. The legislation also extends CHIP – which provides low-cost health coverage to 8.1 million children in the United States – by two years, and secures $7.2 billion in funding to community health centers and the National Health Service Corps.
Murphy said: Thank you all for joining us here for a few moments at one of America’s best hospitals and best hospital systems. I really wanted to bring everyone here today for putting up with this insanity for as long as you did. In 1997 when this was put into place, the intentions were good. There was a runaway Medicare budget and legislators felt that they had to show some seriousness about trying to control Medicare costs. Unfortunately, they did it in the wrong way.
By extending an indiscriminatory cut to every single provider across the country on an annualized basis without any thought about encouraging value, or rewarding those professions that needed plus-ups or needed an expansion of service and scope. And the problem became compounded year after year despite all of these fixes, such that had we not intervened, this would have meant a cut of over 20 percent in reimbursement rates for physicians all across the country.
A credit to all of the lead negotiators to finally figure out that these patches, year after year, were inevitable and unnecessarily expensive; that by patching this SGR year after year, you were actually costing more money than by simply fixing it. And so that’s what we have finally done. We have finally admitted that the policy has been wrong for almost two decades and it’s time to set a new course.
We now have a new formula that guarantees rate increases for providers moving into the future, and provides some certainty for hospitals and physician’s practices who were wondering on an annual basis as to what their level of reimbursement would be. And for Connecticut, which is a state that still relies on not-for-profit institutional acute care, this is especially important because the ability to go out to capital markets and do expansion of infrastructure is reliant on investors believing that they’re going to be able to get a return on an investment. And without any certainty about what rate of reimbursement hospitals and physicians were going to get, it made it very hard for the capital markets to take chances on hospital expansion. Now, hopefully, we have made that process of capital raising a little bit easier for Connecticut institutions.
I do want to talk about the rest of this bill for a moment, because this wasn’t just about a fix to the SGR. Our community health centers, which have grown their capacity at a time when we desperately needed them to grow their capacity as we added tens of thousands to the rolls of the insured, were facing a funding cliff that is exacerbated and solved by this piece of legislation as well. Included in this funding is $7 billion of new funding for community health care centers all across the country that will allow for the expanded access that has been made possible by the economic recovery act and the Affordable Care Act to continue. And so the cliff that would have occurred if physicians had taken a 21% reimbursement cut would have also occurred in community health centers, who would have had to retract a lot of the expansion that has happened all across the state.
The Children’s Health Insurance Program is extended in this bill by two years. Now a lot of us would have liked to have seen that extension for four years or six years, but it’s important to know that the funding that makes Connecticut’s HUSKY program work will be there.
A number of other programs that we really rely on – that a lot of patients rely on – like provisions that allow for expanded access to physical therapy are included in this piece of legislation as well. And so this is primarily about fixing this problem of physician reimbursements forever, but it’s also about some really important funding programs to community health centers, for children’s health care insurance, to physical therapy programs that will continue under this piece of legislation.
Now fixing the SGR isn’t just about budgets for physicians, it’s about making sure that patients have access to physicians; this has always been about patients as well as providers. But I had my first visit last week from a physicians group who led their meeting with an ask for more money for NIH. And I just thought how wonderful this is that we’re going to get to talk about research, and talk about patient safety, talk about technological advancements, instead of just talking about reimbursements. I think there are a lot of good things that are going to come from this fix to a very broken system. Again, thank you to all of you for making this day possible.
Dr. John Rodis, Executive Vice President & COO of Saint Francis Hospital, said: Just a few months ago, doctors learned that they were going to face a 21.2% cut. This would create a significant shortfall in the ability for physicians to provide care. Thanks to recent bipartisan support and the support of our legislators, like our guest today, Senator Chris Murphy, we’re now on a new, more stable path. Chris, thank you so much for your efforts on this important issue and thank you for joining us today to help shed some light on this process that’s going to be more sustainable for years to come.
Dr. Bob Russo, President of Connecticut State Medical Society: It took forever to get this SGR put behind us, and I think it’s important for people to realize why it was such a big step. It froze doctors, it froze hospitals in place. We couldn’t plan; you can’t strategically plan when you don’t know what your business is going to be next year. It froze our capital budgets because we didn’t know all these things. And again, it converted us from what we all think is more important, back to in our business, which is treating and talking about delivery of care, access of care, and the quality of care. Thankfully, Senator Murphy and his staff understand this issue. We’ve been able to work with them, collaborate with them, and I think that there is a new fight – a fight that is going to allow us now to turn our attention from the financial chains that we were in. It’s very complicated in Washington about how things work, but now, I think we’ve identified the right people at the right time to lead us and guide us as to how these changes need to be made. From the bottom of my heart, thank you Senator for everything you’ve done.
Kathy Yaccavone, President & CEO of Southwest Community Health Center, said: Good morning and thank you, Senator, and Saint Francis for sponsoring this event; we really appreciate it. Health centers provide comprehensive medical, dental, behavioral health services to over 350,000 Connecticut residents, and to over 20 million persons in the United States. Health centers across the country were faced with a 70% base grant reduction. If this legislation had not happened, programs would close, providers would have had to have been laid off – providers who are so hard to recruit to begin with – hours of operation would have closed, and over 2,000 clients that we currently serve would have lost access to care. We could not allow that to happen. The bottom line is Senator Murphy understood, and has always understood, the importance of public health care in this country, the safety net, the emergency room, the doctors, the hospitals, the health centers. He was in there fighting; he was in there working a compromise. Two years is essential so that families can still have their children insured through HUSKY B in Connecticut, health centers can keep their doors open, we can recruit physicians through the National Health Service Corps loan repayment, we can work with our colleagues and the hospitals in the private sector to ensure that all elderly people receive services. Without this kind of support, and without the Senator who really gets it, where would Connecticut be? Where would our most vulnerable populations be? We would not have the healthcare that will now be available because of his courage, and his leadership, and his determination, and on behalf of all of the clients and all of the health centers in the state, we thank you, Senator.