Bill raising doctor fees under Medicare would cause premiums to increase

Bill would cause increase in Medicare premiums

WASHINGTON — Seniors would pay $49 billion in higher premiums over the next decade as a result of legislation headed for a House vote that raises fees for doctors treating Medicare patients, according to an estimate by congressional budget officials.

The increase is a result of a federal law requiring premiums to pay one-quarter of the cost of Medicare services for doctors and other outpatient services.

Democratic leaders have slated a vote for Thursday on the bill, which is designed to head off a 21 percent cut in physician fees scheduled for Jan. 1. It is a companion to the controversial health care measure that passed earlier this month.

Brendan Daly, a spokesman for Speaker Nancy Pelosi, said the measure raising fees for physicians would “tackle seniors’ No. 1 concern: that they can keep their doctors. Taken together with the health insurance reform bill which will lower premiums, extend the solvency of Medicare by five years, improve preventive and primary care for seniors, and eliminate the doughnut hole drug coverage gap, it’s a good deal for seniors.”

Ironically, Democrats had once intended to raise physician payments as part of the health care bill that passed on a near-party line vote, but changed course in part to hold down its price tag.

According to an analysis by the Congressional Budget Office, the legislation expected on the House floor this week would raise fees for doctors treating Medicare patients by $194.6 billion over a decade. It also increases fees by $64.4 billion for nonmilitary physicians who care for patients in Tricare, the health care program serving active duty service members as well as National Guard and Reserve members and their families.

“Over the 2011-2019 period, CBO estimates that aggregate Part B premiums would increase by $49 billion,” the agency said in a Nov. 4 written estimate of the impact of the legislation.

Unless Congress acts, doctors in these programs face a cut of 21 percent in their payments effective Jan. 1, a development that could cause some doctors to refuse to see new patients or stop seeing current ones.

As a result, the legislation enjoys support among lawmakers in both political parties, although there has been little if any public acknowledgment of its impact on seniors enrolled in Medicare.

The bill is a top priority for the American Medical Association and AARP, both of which called Tuesday for its passage in written statements.

Dr. Nancy Nielsen, past AMA president, said Medicare patients are responsible for 25 percent of the total cost of Part B of Medicare, “and the projection for their future costs is depressed because current law shows physicians getting a 21 percent payment cut next year.”

David Sloane at AARP said despite any premium increases, the legislation “will make certain that millions of Americans in Medicare will be able to keep their access to and choice of physicians, and that’s why we support it.”

The Senate’s version of the legislation was sidetracked earlier in the fall in a bipartisan rebellion over its impact on the deficit.