The Senate has four days to save the world

The importance of timely Congressional action on the extenders bill and a brief history of the Doc Fix.  

By: Jordan Young  

This afternoon, the Senate invoked cloture on a motion to begin debate on the Continuing Extension Act (H.R. 4851), the legislation to extend by a month Unemployment Insurance, COBRA subsidies, and federal flood insurance senators had left unfinished before skipping town for a two week recess at the end of March. Much has been written on the left and right about Senator Tom Coburn's (R-OK) effort to hold up the legislation unless it was offset by Recovery Act funds. To be frank, I don't think those who are counting on UI benefits or COBRA benefits give a damn about the political points being scored in that debate.  

And neither will doctors who treat Medicare patients on Thursday, when this starts to affect them. The legislation also includes a one month extension of the Medicare SGR Fix. Commonly referred to as the "Doc Fix," this is essentially a case of Congress needing to clean up its own mess.  

In 1997, Congress passed the Medicare Sustainable Growth Rate which attempted to hold down Medicare costs by automatically cutting reimbursements to doctors when costs rose by too much. The problem was the SGR formula was based on an unrealistically low base cost, so for the last decade Congress has been passing temporary legislation every year or so to prevent those cuts from going into effect.  

Come Thursday, without Congressional action, the CMS (Center for Medicare & Medicaid Services) will be forced to begin releasing reimbursements to doctors at a staggering 21.2 percent cut.  

So, Congress now has just a few days to debate and pass this legislation. Once they've done that, they really should think about passing a permanent fix to the SGR formula so Medicare recipients and the physicians who provide them care aren't held hostage to our broken legislative system on an annual basis.