(Mike Chamberlain/Nevada News Bureau) – It is now old news that Senator Harry Reid extolled the virtues of his health care bill before a packed house at UNLV’s Judy Bailey Theater in Las Vegas last Thursday night. Reid said the bill would help Nevada more than almost any other state and cited a Congressional Budget Office (CBO) analysis that estimated the bill would reduce the nation’s deficit by $132 billion over 10 years.
What was not reported is that when a Reid was asked about the cuts to Medicare on which the CBO’s estimates of savings were based, he denied any such cuts exist in his bill and added, “The doctors endorsed our bill because they know that we’re going to do something to take care of them. The AMA endorsed our bill.”
Reid’s statement Thursday night seems to contradict page 18 of the CBO analysis of the Senate health care reform bill which states, “Under current law and under the proposal, payment rates for physicians’ services in Medicare would be reduced by about 21 percent in 2010 and then decline further in subsequent years.”
By all accounts, reversing these reductions would be extremely expensive. A resolution to eliminate the cuts that passed the House last year was estimated by the CBO to cost $210 billion over 10 years, an amount far exceeding the CBO’s estimated $132 billion savings of Reid’s health care reform bill.
The original Senate health care bill did contain a provision (Section 3101, p. 783) that would have replaced the 21% cut to reimbursements to doctors in 2010 with a 0.5% increase in Medicare’s physician reimbursements that year. It then provided for even greater cuts in 2011. But the manager’s amendment that was added to the bill by Senator Reid the week before Christmas repealed that provision and restored the original cuts for 2010 (Sec 10310, p. 2191).
An analysis of the Senate health care bill by the Centers for Medicare and Medicaid Services (CMS) of the Department of Health and Human Services expressed concern over the impact such cuts could have on the ability of Medicare to provide care. The report stated (p. 9), “[P]roviders for whom Medicare constitutes a substantive portion of their business could find it difficult to remain profitable and, absent legislative intervention, might end their participation in the program (possibly jeopardizing access to care for beneficiaries).”
In a move that is seen as the first in a possible industry trend, the Mayo Clinic recently decided to take fewer Medicare patients. Mayo has said it will no longer accept Medicare patients at one of its Arizona clinics and that it is in the process of determining whether it should also drop Medicare patients at other facilities in Arizona, Florida and Minnesota, which combined serve more than 500,000 seniors.
Mayo says it lost $840 million last year treating Medicare patients, the result of the program’s already low reimbursement rates.
In Nevada, approximately 340,000 beneficiaries are currently eligible for Medicare.
Audio of the question(s) about Medicare cuts and Senator Reid’s answers from Thursday night here.
Following is the transcript (Reid was exiting the auditorium so the audio contains background noise):
Q: Isn’t it true that if the doctor’s fix for Medicare reimbursements for doctors is taken out of the bill that all of the budget savings would disappear? And that there’s already pending legislation to do that – to reverse that?
Senator Reid: No, because we pay for that. It’s going to be something we’re paying for.
Q: But it’s included in the bill, and that’s part of the CBO scoring for that savings.
Reid: Our bill has nothing in it for the doctors.
Q: It doesn’t reduce, the twenty, the reimbursements to Medicare doctors by 21%?
Reid: Anything we do for the doctors is going to be paid for. We disagree with the House.
Q: Okay. But it does not reduce the Medicare reimbursements to doctors, your bill?
Reid: No. Nothing, there’s nothing, there’s not. And the doctors endorsed our bill because they know we’re going to do something to take care of them. The AMA endorsed our bill.