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Learn about policy issues important to medical schools and teaching hospitals, with Executive Vice President Atul Grover, M.D., Ph.D.

Washington Highlights

House Passes Bipartisan Budget Bill

December 13, 2013—The House of Representatives Dec. 12 voted to approve a bipartisan budget agreement to establish discretionary spending caps for fiscal years (FYs) 2014 and 2015 and provide a temporary delay for cuts to Medicare physician payments.  The House passed the legislation 332-94, with 169 Republicans and 163 Democrats voting yes. 

The legislation would set the limit for discretionary (appropriated) spending in FY 2014 at $1.012 trillion, which is about $26 billion more than the current spending level of $986 billion in the current continuing resolution (CR, P.L. 113-46) that expires Jan. 15. Overall, the legislation eliminates $63 billion in sequestration cuts in FYs 2014 and 2015.

The Congressional Budget Office (CBO) says the legislation will reduce the federal deficit by a total of $23 billion over the next 10 years.

The legislation also includes the Pathway for SGR Reform Act, which contains the following important health care-related provisions:

  • Three-month Medicare physician payment patch that prevents a 20.1 percent physician payment cut due Jan. 1, 2014;

  • Provision increasing Medicare physician reimbursement by 0.5 percent through March 2014; and
  • Provision delaying the scheduled 2014-15 Medicaid Disproportionate Share Hospital (DSH) cuts until 2016.

In a Dec. 11 statement, AAMC President and CEO Darrell G. Kirch, M.D., said, “We are disappointed, however, that the proposal leaves in place the sequestration cuts to Medicare and extends them for two years…. In addition, we are disappointed that the Pathway amendment does not include a provision to address the ‘Two-Midnight Rule.’ This is an issue we urge Congress to address as Medicare physician payment reform moves forward in 2014.”

However, the AAMC supported the overall legislation and urged the House and Senate to pass it in a Dec. 12 letter.

Senate Budget Committee Chair Patty Murray (D-Wash.) and House Budget Committee Chair Paul Ryan (R-Wis.), announced the budget agreement at a joint press conference Dec. 10.

Democrats expressed disappointment that the legislation does not extend expanded unemployment benefits set to expire at the end of December.  The legislation also does not tackle the debt ceiling, which must be addressed in early February.

The Senate is expected to vote on the package during the week of Dec. 16. The president has indicated he will sign the legislation.


Dave Moore
Senior Director, Government Relations
Telephone: 202-828-0559


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Jason Kleinman
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Telephone: 202-903-0806