Morning Bell: Exposing the Obamacare Shell Game

Conn Carroll / October 19, 2009

In his primetime health care address before a Joint Session of Congress, President Barack Obama promised the American people: “I will not sign a plan that adds one dime to our deficits – either now or in the future. Period.” But it is hard work adding $1 trillion in government spending while claiming with a straight face that you are not adding to the deficit. Enter White House Chief of Staff Rahm Emanuel who has just the solution: just strip out $247 billion of the spending in the bill, pass it separately, and voila … your job just got one-fourth easier.

The specific issue at hand is the centrally planned price control regime the federal government uses to reimburse doctor’s who participate in Medicare. Medicare reimburses doctors and other medical professionals for their services according to a congressionally created fee schedule that is annually adjusted by the Sustainable Growth Rate (SGR) formula. The idea is relatively simple: If Medicare spending grows faster than our overall economy (which is almost always the case), then payments to Medicare providers are supposed to be reduced proportionately to keep expenditures in line over a period of time.

Problem is every year Congress–under both Democratic and Republican leadership–routinely blocks the cuts from going into effect. Subsequently, the necessary cumulative cut in Medicare payments grows bigger. Without a change to current law, payments to physicians would be reduced by 21.5% as of January 1, 2010. The Senate Finance Committee bill addresses this problem by raising the reimbursement rate for one year and then pretending that Congress will allow massive cuts for the next 9 years. House Majority Leader Steny Hoyer (D-MD) rightfully called the Senate Finance Committee proposal a façade. (more…)