The American Medical Association began laying the groundwork for negotiations in the lame duck session to deal with the “fiscal cliff” in 2010 by urging the Simpson-Bowles Commission to include a permanent repeal of the Medicare sustainable growth rate (SGR) formula in its budget deficit proposal. Last month, the AMA led an effort to outline principles for transition to a new Medicare payment system that was endorsed by 48 states and over 60 national specialty societies. Congress has heard repeatedly from the AMA and other physician groups on the need for action to avert the 27 percent SGR cut on Jan. 1 and the additional 2-percent sequestration cut that will occur as a result of a previous failure to reach agreement on a deficit reduction package.
While there is a great of deal of uncertainty regarding how Congress and President Obama will address the “fiscal cliff,” the AMA is poised to deal with a range of scenarios. Many observers anticipate a two-step process in which an initial deficit reduction package is enacted during the lame duck session that prevents SGR and sequestration cuts. This would include or be accompanied by a framework for a larger deficit reduction package to be finalized next year.
At the onset of the process, the AMA’s objectives are:
- Avert looming SGR and sequestration cuts
- Permanent repeal of the SGR and transition to new Medicare payment system that rewards physicians for high-quality care and savings across the delivery system
- Medical liability reforms to reduce the cost of defense medicine
- Preserve investments in graduate medical education, research, public health and prevention
The AMA will engage state and national medical societies, as well as individual patients and physicians, throughout the negotiations through grassroots alerts, various AMA communications channels and Federation conference calls.