Senate health reform bill wins AMA backing

Washington -- The American Medical Association announced Dec. 21 that it would support passage of the Senate's health system reform bill, which was moving toward a planned final vote during a rare Christmas Eve session.

AMA President-elect Cecil B. Wilson, MD, appeared with Senate Majority Leader Harry Reid (D, Nev.) and several other top Democratic lawmakers at a Capitol Hill event to call for Senate passage of the Patient Protection and Affordable Care Act.

On Dec. 19, Reid unveiled a revised final version of the overhaul legislation, along with a package of additional proposed amendments designed to garner the 60 votes necessary to move to a final vote on the bill.

"All Americans deserve affordable, high-quality health coverage so they can get the medical care they need -- and this bill advances many of our priority issues for achieving the vision of a health system that works for patients and physicians," Dr. Wilson said. He cited insurance reforms, preventive care expansions and comparative effectiveness research provisions as some of the key issues the bill tackles.

As the Senate began floor consideration of a comprehensive reform measure in late November, AMA leaders said they would reserve judgment on the bill until later in the debate, though they listed numerous concerns with the legislation as written. In endorsing the amended version of the bill, they noted that Democrats made several revisions important to physicians.

For instance, the legislation retains a Medicare bonus for some primary care physicians and general surgeons but no longer offsets the cost with pay reductions to other doctors, Dr. Wilson said. In addition, the bill no longer has provisions to tax elective cosmetic surgery procedures and charge physicians a fee to enroll in Medicare.

Reid also heeded an AMA call to remove a one-year Medicare pay patch from the legislation, which would have averted the planned 21.2% cut for 2010 but allowed the sustainable growth rate formula to impose an even larger reduction in 2011.

The Association will not support any more temporary solutions to the long-term pay problem, AMA Executive Vice President and CEO Michael D. Maves, MD, MBA, wrote in a Dec. 21 letter to Reid. A newly enacted defense appropriations bill postpones the 21.2% cut until March 1 to give lawmakers more time to act on a stand-alone Medicare pay reform bill.

"Congress must replace the SGR early next year in order to achieve the access, payment and delivery reform goals envisioned by" the broader Senate health reform bill, Dr. Maves wrote. The AMA will not support a final House-Senate health system reform bill unless lawmakers also commit to a "clear pathway for passage of a permanent repeal of the SGR formula early next year."