AMA supports House bills on health reform, Medicare pay

Two days before the U.S. House of Representatives planned to vote on a major health system reform bill, the American Medical Association came out in support of that measure and a companion bill that would address long-term Medicare pay for doctors.

AMA President J. James Rohack, MD, announced the Association's support for the Affordable Health Care for America Act during a Nov. 5 conference call with reporters as House Democratic leaders prepared the legislation for floor consideration. Leaders were aiming for an unusual Saturday vote on the primary reform bill on Nov. 7 but had not yet scheduled a floor debate for the Medicare Physician Payment Reform Act of 2009. That bill would repeal the sustainable growth rate formula that determines doctors' rates.

"These are separate bills but must be passed together," Dr. Rohack said. "Both are essential to achieving meaningful health system reform this year."

But Dr. Rohack stopped short of saying the Association would definitely withdraw its support for the larger health system overhaul bill if the Medicare pay piece did not accompany it. He also noted that the AMA's support for the Affordable Health Care for America Act was not a full endorsement, saying the legislation meets the organization's main principles for health system reform but still needs improvement.

"This legislation isn't perfect, but this debate is not over, and the work is not done," Dr. Rohack said. "The AMA will continue to work constructively with members of Congress and the White House to improve legislation and to make sure the voices of physicians and our patients are heard."

Because of the speed at which the bill was proceeding in the House, the AMA stated its position before the official start of its Interim Meeting, Dr. Rohack said. The AMA's policymaking House of Delegates is scheduled to meet in Houston Nov. 7-10.

The AMA is still seeking changes to the House reform bill, Dr. Rohack said, including a provision to open up more graduate medical education slots in general surgery, childhood and adolescent psychiatry, addiction medicine and other areas where training opportunities are lacking. The current bill expands GME only in primary care.

Dr. Rohack acknowledged that at least two state medical societies, the Texas Medical Assn. and the Illinois State Medical Society, came out against the House system reform legislation before the floor vote. But he also noted that numerous medical specialty organizations have joined the AMA in supporting the House bill.