Senate to vote on SGR Monday

On Oct. 13, Sen. Debbie Stabenow (D-Mich.) introduced S. 1776, the "Medicare Physicians Fairness Act of 2009," which the Senate leadership announced yesterday will serve as the Senate legislative vehicle for eliminating Medicare's sustainable growth rate (SGR) formula and laying the foundation for establishing a new Medicare physician payment update system.

S. 1776 will be the subject of a cloture vote on Monday, Oct 19. The Senate needs 60 votes to invoke cloture to allow formal consideration of the bill. A vote on final passage is expected to occur late next week, either on Oct. 22 or 23. Senate Majority Leader Harry Reid (D-Nev.), Senate Finance Committee chairman Max Baucus (D-Mont.), and Sen. Chris Dodd (D-Conn.), along with President Barack Obama, are all strongly supporting passage of S. 1776.

Sen. Stabenow's 18-line bill repeals the SGR formula and eliminates all debt that has been accumulated under the current payment system, setting future physician payment updates at zero. Importantly, the Senate leadership made it very clear yesterday that Congress does not intend to implement a permanent physician payment freeze and call it Medicare payment reform.

Rather, by passing a separate bill that repeals the SGR and eliminates the accumulated spending target debt, budget constraints will be eased, allowing a new physician payment update system to be incorporated into a broader health system reform bill. The details of that future update system have not yet been worked out, although certainly the two spending targets that would be created by the U.S. House of Representatives health system reform legislation, H.R. 3200, could be viewed as a starting point.

The procedural path for passing S. 1776 will be complicated, requiring the support of 60 senators on several procedural motions over the next few days. Furthermore, because the legislation is not offset by other spending cuts or revenue increases it will add to the federal budget deficit, raising its controversy and making supporting votes difficult for some senators.

Repealing the SGR is one policy objective that is a common goal for all physicians. Sen. Stabenow's bill creates the pathway the AMA has been seeking to finally achieve that goal. Grassroots activism will be absolutely critical to the success of this strategy.

The AMA has activated its physician and patient grassroots networks, and will be running television advertisements in key states. A unified and concentrated effort by the entire house of medicine will be essential to the AMA's success.

Visit the AMA's grassroots action center to send an e-mail to your senator. Also, the AMA grassroots hotline at (800) 833-6354 can connect you directly to your senator's office.