Family Physicians Dismayed at Congressional Failure To Act on Medicare, Medicaid Issues

Thursday, Dec. 11, 2014

Statement attributable to:
Robert Wergin, MD
American Academy of Family Physicians

“Congressional claims that lawmakers want to save unnecessary spending and ensure access to health care are disingenuous.

“Despite their rhetorical goal to trim federal spending, the 113th Congress failed to repeal the sustainable growth rate formula that determines Medicare payment for care provided to elderly and disabled Americans. Instead, last spring, legislators perpetuated the cycle of increasingly expensive temporary patches when they put aside substantive legislative proposals to repeal the SGR and instead resorted to a 17th short-term extension in order to prevent a double digit cut to physician Medicare payment.

“Equally disappointing, Congress failed to preserve Medicaid payment parity with Medicare for primary care services.

“One in four patients in family physician offices are Medicare beneficiaries. Nearly two in 10 of their patients rely on Medicaid. No family medicine practice can sustain such devastating pay cuts without compromising the financial foundation of their practices.

“Family physicians across the nation are dismayed. The 113th Congress could have avoided the current temporary “SGR fix” that ends March 31. The House and Senate had before them a bipartisan bill to repeal the SGR for $118.9 billion—far less than the $170 billion spent so far continuously passing temporary patches. But lawmakers could not agree on how to pay for a permanent solution.

“The next Congress will have to find $21 billion before April 1 just to pass another temporary patch to prevent the 21 percent pay cut required by the formula.

“The inability to repeal the SGR comes on the heels of another congressional failure. Despite the inevitable pay cut of up to 40 percent for primary care provided to low-income working families, Congress did not preserve a program that paid Medicare rates for primary care services provided by primary care physicians to Medicaid beneficiaries. As a result family physicians will see payment slashed for the care they provide to working families receiving Medicaid benefits. This cut in Medicaid payment may result in having less access to physicians in their offices and push patients to be seen in the more costly emergency room, actually increasing the total cost of care.

“No medical practice can sustain such steep drops in payment and keep their doors open to serve patients. This destabilizing environment cannot continue. The cost to Americans’ well-being and to the nation’s coffers is too high.

“The American Academy of Family Physicians will work with the 114th Congress to ensure early action on legislation that repeals the flawed SGR, reestablishes Medicaid payment to Medicare levels for primary care, and restores health care security to Medicare and Medicaid beneficiaries.”

Editor's Note: To arrange an interview with Dr. Wergin, contact Leslie Champlin, (800) 274-2237, Ext. 5224, or




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Founded in 1947, the AAFP represents 124,900 physicians and medical students nationwide. It is the only medical society devoted solely to primary care.

Family physicians conduct approximately one in five office visits -- that’s 192 million visits annually or 48 percent more than the next most visited medical specialty. Today, family physicians provide more care for America’s underserved and rural populations than any other medical specialty. Family medicine’s cornerstone is an ongoing, personal patient-physician relationship focused on integrated care.

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