Good news, you’d think, for doctors and the broader healthcare system, that we might finally be rid of the SGR’s broken machinations and perverse cycle of congressional intervention.
But House leaders added a footnote: the measure would be paid for by delaying the individual mandate, which CBO opined last week would save money through reduced enrollment in Exchanges and Medicaid. To cover the approximate $150 billion cost of the SGR measure, the mandate would probably need to be delayed by at least 10 years.
While sparing us a rehash of the individual mandate debate here, suffice it to say that the Obama Administration, the authors of the Affordable Care Act, and most healthcare insurers and providers consider it to be a linchpin of the health reform regime.
Without it, most agree, the consumer protections established by the ACA would precipitate spiraling premiums that would quickly destroy the market.
In other words, the House measure is DOA in the Democrat-controlled Senate and White House, which House leaders know all too well. In a move whose political deftness is hard to quibble with, they are coupling two very popular measures into a single package that they know the vast majority of Democrats can’t support.
Good politics? Probably. Good for enactment of SGR repeal? More like the opposite.
But don’t blame House leaders for the demise of SGR repeal. This move is a symptom, not a cause, of its end. As previously reported, the well-intentioned negotiators were having difficulty finding common ground on the so-called extenders package that would be included, and were miles apart on the offsets that would be used to fund it.
This train had already come off the tracks.
Not to be outdone, early buzz this weekend is that Senate Democrat leaders may pair SGR repeal with an extension of unemployment insurance. As they mirror the House strategy of pairing two popular measures that their opponents can’t support, we now seem to be entering a sort of arms race, with each side trying to build the perfect legislative weapon to fire at the other.
Unfortunately, SGR repeal is sitting at the tip of their warheads.
This is just a bit of fun melodrama on a Sunday afternoon, because it’s really just another round of politics as usual in Washington (queue the violins for a looong collective sigh…). The midterm elections might seem a ways away to you and me, but in Congress, they might as well be tomorrow.
And the glimmer of hope that permanent SGR repeal would come this spring is one of the first victims of the election cycle.
Billy Wynne is the Founder and CEO of Healthcare Lighthouse, a one-stop shop for comprehensive policy information for healthcare organizations and businesses. He is also a Partner at the Washington policy and lobbying firm Thorn Run Partners. Previously, he served as Health Policy Counsel to the Senate Finance Committee.