Senate negotiations take a new turn

[CAL/AAEM News Service]

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December 10, 2009

Senate negotiations take a new turn


The American Medical Association<http://www.ama-assn.org/>

As Senate floor debate continues this week, negotiations between a handful of liberal and moderate Democrats appointed by Senate Majority Leader Harry Reid (D-Nev.) produced an alternative proposal to the public insurance option outlined in H.R. 3590, the "Patient Protection and Affordable Care Act."

The proposal is under review by the Congressional Budget Office and legislative language is not yet available, but it reportedly involves: (1) allowing individuals 55-64 years of age without access to employer-sponsored insurance to purchase coverage under Medicare; (2) making national plans offered by private insurers and managed by the federal Office of Personnel Management available to individuals obtaining coverage through the health insurance exchange; and (3) creating a "trigger" mechanism through which a new public plan would be developed if private companies are unable to deliver acceptable national insurance policies. Finer details of the proposal and the extent of agreement among senators who were not directly involved in the negotiations are not yet known.

The AMA has expressed opposition to the proposed Medicare expansion, given current problems with the program, and has issued a grassroots alert urging physicians to contact their senators. Other physician and provider groups, including major hospital associations, share our concerns. Physicians are encouraged to contact their senators using the AMA's grassroots hotline at (800) 833-6354 to express opposition to the proposal, based on the following concerns:

*      Many physicians have been forced to stop accepting Medicare patients because of the program's burdensome regulations and unstable payment system. Adding more patients to Medicare will force more physicians to make this difficult decision.

*      Medicare payment rates have failed to keep pace with practice cost increases; and the program's balance billing and private contracting limits are so rigid that costs have been shifting to the private sector. Adding a new patient population to the program will only increase this cost shifting, raising premiums and health care costs for other Americans.


Abid Mogannam &
Brian Potts MD, MBA
Managing Editors, CAL/AAEM News Service
University of California, Irvine
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