Repealing health reform law could have dire effects, CMS chief tells Congress

Washington -- Repealing the Patient Protection and Affordable Care Act would have devastating consequences for seniors and the Medicare program, Donald M. Berwick, MD, told Congress on Nov. 17.

Dr. Berwick, administrator of the Centers for Medicare & Medicaid Services, outlined the health system reform law's recent successes to the Senate Finance Committee, including a "home health" project under way in Medicaid and efforts to fight fraud and help reduce improper payments through the expanded use of recovery audit contractors.

"These innovative provisions will enable CMS to work with our partners in the private sector to improve care coordination, increase patient safety, offer beneficiaries more information and more control over their care, and achieve better outcomes," Dr. Berwick said.

He told senators that efforts by some Republicans to repeal all or parts of the reform law could have a negative impact on patients' access to care and services.

For example, Medicare's hospital trust fund would be bankrupt in 2017; seniors would have to pay more for prescription drugs and pay out-of-pocket for preventive services; and a new authority to prevent and punish fraud would be rolled back, Dr. Berwick testified.

He also pointed to the launch of the Center for Medicare and Medicaid Innovation as a positive step toward researching and adopting more effective payment and delivery models.

Senate Finance Committee Chair Max Baucus (D, Mont.) agreed. "Repealing the new law would return us to the failures of the old system. [It] would cause Medicare to go broke in just six years. [It] would increase the deficit by hundreds of billions of dollars. [It] would put insurance company bureaucrats back in charge of health care. And repealing the new law would threaten seniors' health with duplicative care and poor coordination."

Committee Republicans pointed out that Dr. Berwick has an enormous responsibility at CMS, overseeing more than 4,400 employees and an annual budget of more than $700 billion.

"The partisan health care overhaul will add about 16 million people to the Medicaid program, with a total price tag for the federal government of about $434 billion," said ranking member Charles Grassley (R, Iowa).

"This expansion will begin under your watch. In addition to this massive coverage expansion, you have been given unprecedented authority to implement new payment and delivery models. Your decisions in this area will influence a significant amount of economic activity and determine how the new health law affects the health care coverage that millions of Americans rely on."