Congress must prevent cuts to Medicare

As painful as COVID-19 will remain for the foreseeable future, there are encouraging signs that we may soon mark real progress toward recovery. The pace of vaccinations is accelerating while the number of new cases in many states — and most importantly, the rate at which people are dying from the virus — continues to decline.

The severe economic pain of this pandemic shows signs of recovery as well, but there remains a fast-approaching threat to private physician practices that jeopardizes patient care at a moment when it is needed most.

Independent physician practices play a vital and often overlooked role in the larger health system, and we are frequently the only touchpoints our patients have within the wider health care safety net. We are more than simply our patients’ doctors; we are called to be their counselors, their advisers, their confidants, and in the case of a health emergency like we face, a counterweight to misinformation or exaggerated claims they have read online.

While the American Rescue Plan Act of 2021 promises to bring financial relief and extend health insurance to tens of millions of people across the country, the stimulus package fails to address an imminent threat to the financial viability of physician practices: the April 1 expiration of the existing moratorium on the 2 percent Medicare sequester. Even worse, the package triggers a second and even more severe threat on Jan. 1, 2022: an additional 4 percent Medicare sequester that would devastate independent practices that already have suffered tremendously during COVID-19.

In-person patient visits to physician offices plummeted last year, and physicians saw revenue drop by an average of 32 percent, according to an AMA survey conducted last summer. About one in every five physicians saw revenue collapse of 50 percent or more, and more than eight in 10 physicians said revenue still has not recovered to pre-pandemic levels.

As leaders of health care teams, physicians routinely put their lives on the line by placing the needs of patients above their own. Policymakers should consider the physical and emotional strain placed on them before further aggravating their financial burden by cutting Medicare payments.

In passing the first stimulus relief package a year ago, Congress recognized that burden and placed a moratorium on Medicare sequestration for the remainder of 2020. The second stimulus bill, signed into law in December 2020, extended that moratorium through March 31, 2021. But the American Rescue Plan Act provided no further extension.

Further complicating matters, an analysis by the Congressional Budget Office projects this law will trigger a 4 percent statutory “pay as you go” reduction in Medicare spending for 2022. This would place additional financial pressure on physician practices that are already struggling with reduced patient volume and revenue, as well as higher expenses for PPE and other supplies.

The House has taken the first step to remedy the situation. On March 19, the House passed H.R. 1868 with bipartisan support. It would address both of these threats to Medicare reimbursement. This proposal would prevent harmful across-the-board spending cuts which pose a corresponding threat to patient care by inflicting a devastating financial blow on private physician practices amid a pandemic.

Enacting the provisions of H.R. 1868 will allow physicians and others in the health care to focus on bringing the pandemic to a close and eliminate the financial uncertainty tied to reduced Medicare reimbursement. Physicians need all the support and assistance we can provide in the fight against COVID-19, and H.R. 1868 is a vital step in this direction.

Susan R. Bailey, MD, is president of the American Medical Association.