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Washington Highlights

Challenges Remain for Passage of Bipartisan SGR Legislation

March 21, 2014— The House of Representatives March 14 passed (238-181) an amended version of the Medicare Sustainable Growth Rate (SGR) Repeal and Medicare Provider Payment Modernization Act (H.R. 4015), adding a five-year delay in tax penalties for individuals who do not obtain health insurance coverage under the Affordable Care Act (ACA, P.L. 111-148 and P.L. 111-152) to offset the cost of the SGR bill.

The original bipartisan, bicameral legislation [see Washington Highlights, Feb. 7] had significant support but the inclusion of the individual mandate delay likely means the legislation will not be able to pass the Senate. The Office of Management and Budget (OMB) March 12 issued a Statement of Administration Policy indicating the administration’s strong opposition to H.R. 4015 if it includes the ACA individual mandate delay and that the president would veto the legislation.

Senate Finance Committee Chair Ron Wyden (D-Ore.) March 11 introduced the Medicare SGR Repeal & Beneficiary Access Improvement Act of 2014 (S. 2110) without offsets. The revised legislation differs from the original bipartisan SGR proposal by including certain Medicare “extenders” that were previously included in the Senate Finance Committee’s mark [see Washington Highlights, Dec. 13, 2013]. The Congressional Budget Office (CBO) March 19 scored S. 2110 at $180 billion over 10 years.

Additionally, Sens. Orrin Hatch (R-Utah), Mitch McConnell (R-Ky.), and John Cornyn (R-Texas) introduced an alternative Senate Republican SGR replacement bill, the Responsible Medicare SGR Repeal and Beneficiary Access Improvement Act (S. 2122), which adds the individual mandate repeal to the original bipartisan SGR proposal.

Congress returns March 24 from recess with just days before the current patch expires on March 31. Should Congress fail to act, doctors face a 24 percent cut to Medicare reimbursement payments.  


Len Marquez
Director, Government Relations
Telephone: 202-862-6281

Courtney Summers
Senior Legislative Analyst
Telephone: 202-862-6042


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Washington Highlights, a weekly electronic newsletter, features brief updates on the latest legislative and regulatory activities affecting medical schools and teaching hospitals.

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Jason Kleinman
Sr. Legislative Analyst, Govt. Relations
Telephone: 202-903-0806