American Medical Association President Cecil B. Wilson, M.D. recently testified before the House Energy and Commerce Health Subcommittee about the need to move beyond the Sustainable Growth Rate (SGR). Without action by Congress, the SGR will trigger a Medicare physician payment cut of nearly 30 percent on January 1, 2012. Video of Dr. Wilson’s testimony can be found below.

Legislation concerning one of the American Medical Association’s top issues — medical liability reform — is moving forward in the U.S. House as the Energy and Commerce Committee considers H.R. 5, the Help Efficient, Accessible, Low-cost Timely Health Care (HEALTH) Act.

America’s patients, physicians, and taxpayers are breaking under the weight of meritless medical liability lawsuits. The numbers tell the story:

The current medical liability system fails both patients and physicians — it hurts the quality of patient care and costs the nation billions. For the health of American, we need medical liability reform now.

Patients can get involved and show support for H.R. 5 and medical liability reform by joining the AMA’s Patients’ Action Network (PAN). After joining, take these steps in support of H.R. 5.

1. Sign-up for the PAN and email your legislators.
2. Learn if your representative has sponsored or co-sponsored H.R. 5.
3. Call your representative using the toll-free PAN hotline at (888) 434-6200 and ask them to co-sponsor H.R. 5. If they have already co-sponsored H.R. 5 thank them for supporting medical liability reform.
4. Follow the PAN on Facebook and Twitter for the latest news on medical liability reform and other issues affecting patients’ access to care.

To learn more about medical liability reform please visit our issue page.

There are a total of 20 physician members of the 112th Congress including three senators, 16 representatives and a delegate. This up from 16 physician members in the 111th Congress, an increase of 25 percent. Family medicine and obstetrics/ gynecology are the most represented medical specialties with four members each. Emergency medicine, ophthalmology and orthopedic surgery are each represented by two members of Congress while general surgery, cardio-thoracic surgery, thoracic surgery, gastroenterology, anesthesiology and psychiatry are represented with a single member.

Learn more about the 20 physician members of Congress by connecting with them on Facebook, Twitter and YouTube.

House of Representatives

Rep. Dan Benishek, MD (R-MI-01)
General Surgery

Rep. Charles Boustany, MD (R-LA-07)
Cardio-Thoracic Surgery

Rep. Paul Broun, MD (R-GA-10)
Family Medicine

Rep. Larry Bucshon, MD (R-IN-08)
Thoracic Surgery

Rep. Michael Burgess, MD (R-TX-26)
OB/GYN

Rep. Bill Cassidy, MD (R-LA-06)
Gastroenterology

Del. Donna Christensen, MD (D-VI-AL)
Emergency Medicine

Rep. Scott DesJarlais, MD (R-TN-04)
Family Medicine

Rep. John Fleming, MD (R-LA-04)
Family Medicine

Rep. Phil Gingrey, MD (R-GA-11)
OB/GYN

Rep. Andy Harris, MD (R-MD-01)
Anesthesiology

Rep. Nan Hayworth, MD (R-NY-19)
Ophthalmology

Rep. Joe Heck, DO (R-NV-03)
Emergency Medicine

Rep. Jim McDermott, MD (D-WA-07)
Psychiatry

Rep. Ron Paul, MD (R-TX-14)
OB/GYN

Rep. Tom Price, MD (R-GA-06)
Orthopedic Surgery

Rep. David “Phil” Roe, MD (R-TN-01)
OB/GYN

Senate

Sen. John Barrasso, MD (R-WY)
Orthopedic Surgery

Sen. Tom Coburn, MD (R-OK)
Family Medicine

Sen. Rand Paul, MD (R-KY)
Ophthalmology

The multiple Medicare patches Congress passed in 2010 were only temporary reprieves for seniors and baby boomers who rely on the promise of Medicare. Delaying the problem is not a solution.

In January 2012, the Medicare physician payment cut will be a whopping 25 percent. Congress is playing a dangerous game of Russian roulette with seniors’ health care. Sick patients can’t wait. Congress must replace the broken payment system before the damage is done and cannot be reversed.

Seniors are already experiencing access problems as a result of the complete congressional mismanagement of Medicare over the years. Baby boomers begin entering Medicare in 2011, and if the physician payment problem isn’t fixed, these new Medicare patients won’t be able to find a doctor to treat them.

Failure by Congress and the Obama Administration to properly solve this issue will intensify access problems for seniors and military families enrolled in the TriCare program, and severely undermine implementation of recently enacted health system reform legislation. An existing physician shortage will be magnified and steeper cuts will prevent practice and delivery innovations.

Tell your members of Congress that it is time to end their mismanagement of these important health care programs, and honor their commitment to military families and older Americans. It is long past time for Congress to find a long-term solution to the SGR that does not create an even bigger problem in the future.

About one in four Medicare patients looking for a new primary care physician are having trouble finding one. About one in five physicians are already limiting the number of Medicare patients they treat because of the instability and uncertainty of Medicare payment. Couple these facts with a government-predicted shortage of 85,000 physicians by 2020 and the future for Medicare patients’ access to care is bleak—unless we take steps to turn the tide.

Please contact your members of Congress. Urge them to avert the 25 percent cut without increasing the cost of a permanent solution, and preserve access to medical services for Medicare patients and military families. Tell them enough is enough! Growing the problem is not the solution!

The Patient Protection and Affordable Care Act (H.R. 3590)—health system reform legislation signed into law by President Obama on March 23—contains a number of key provisions for patients. Some provisions may have an immediate impact, while others will not take effect for some time.

While we have compiled a number of resources about What Could Health System Reform Mean for You?, below is a snapshot of the benefit timeline.

Patient benefits that take effect in 2010

For patients with private health insurance:

• Your insurer can no longer drop you from your plan if you get sick.
• Children ages 18 and younger can no longer be denied private insurance coverage if they have a pre-existing medical condition.
• For adults with pre-existing medical conditions who cannot obtain private insurance coverage, a temporary national “high-risk pool” will be established to provide coverage, with financial subsidies to make premiums more affordable, until all insurers are required to cover people with pre-existing conditions in 2014.
• Young adults up to age 26 can remain as a dependent on their parents’ private health insurance plan.
• Your health insurance benefits can no longer run out because of a long or expensive illness because insurers can no longer impose lifetime financial limits on benefits.
• Preventive services for women, such as mammograms, and immunizations for children must be covered by insurers, with no co-payments or deductibles required.

In addition, Medicare patients who will hit the coverage gap known as the “doughnut hole” this year under the prescription drug benefit will receive a $250 rebate from Medicare.

Patient benefits that take effect during the next four years

In the private health insurance market:

• U.S. citizens and legal residents cannot be denied private health insurance coverage for any reason, beginning in 2014. All U.S. citizens and legal residents must obtain health insurance coverage or pay a minor tax penalty (although there are some exemptions). This is to ensure that everyone is in the insurance pool so no one can get a “free ride” by not having affordable coverage and then going to an emergency room for care.
• State-based health insurance exchanges will begin operating in 2014, where people who do not have access to employer-based insurance can shop and compare the benefits and costs of private health insurance plans. These exchanges will create insurance pools that will allow people to choose among affordable coverage options. All insurance companies in the exchange must provide at least a minimum benefit package, as well as additional coverage options beyond a basic plan.
• Federal subsidies through tax credits or vouchers will be provided in 2014 to people who cannot afford the full cost to help them purchase coverage through the exchanges.
• Beginning in 2011, states can require insurance companies to submit justification for premium increases and can impose penalties for excessive increases.

For patients enrolled in Medicare or Medicaid:

• You no longer will pay any cost-sharing for a number of preventive services, effective Jan. 1, 2011.
• If you are subject to the “doughnut hole” for your Medicare drug coverage, you will receive a 50 percent discount on those prescription drugs beginning Jan. 1, 2011.
• A series of pilot programs will be implemented during the next four years to help find new ways to improve quality and lower the cost of the care you receive from your doctors, hospitals and nursing homes in the Medicare and Medicaid programs.
• Medicaid coverage will be expanded in 2014 to all eligible children, pregnant women, parents and childless adults under age 65 who have incomes at or below 133 percent of the federal poverty level.

Curious as to what the recent health system reform legislation means for you? Check out the following resources:

• Frequently asked questions about health system reform legislation – AMA
• Consumers’ Big Question: What’s in It for Me? – New York Times
• What does the health-care law mean to me? – Washington Post
• Health care: What you could see – USA Today
• How the health care overhaul could affect you – New York Times
• Q+A: How does healthcare overhaul affect Medicare? – Reuters
• The immediate effects of the health reform bill – Kaiser Health News
• 5 key things to remember about health care reform – CNN
• True or False: Seven Concerns About The New Health Law – Kaiser Health News
• Top 10 facts to know about health care reform – Politifact.com
• Health Care Reform Explained – AARP Bulletin
• What will health reform mean for you? – White House

Let us know if you come across any good sources of information and we will add it to this list.

Late Sunday evening (3/21/2010) the U.S. House of Representatives passed H.R. 3590, the Patient Protection and Affordable Care Act, as well as the reconciliation bill, H.R. 4872, the Health Care and Education Affordability Reconciliation Act, which contains additional refinements. Together, the two bills are viewed as the most important health care legislation since the creation of the Medicare program.

H.R. 3590 and the related reconciliation bill provides a historic opportunity to help millions of patients by extending coverage to 32 million Americans, improving competition and choice in the insurance marketplace, promoting prevention and wellness, reducing administrative burdens and protecting the fundamental principles of the patient-physician relationship. After carefully weighing the benefits and the shortcomings, the AMA announced its qualified support for passage of H.R. 3590 because we believe it will improve the ability of patients and their physicians to achieve better health outcomes.

The health system reform legislation remains an imperfect product. Action to permanently repeal the Medicare sustainable growth rate (SGR) formula was separated from health system reform legislation months ago. The AMA is engaged in active discussions with the Obama Administration as well as House and Senate leaders on bringing SGR legislation for a vote this spring in a separate piece of legislation.

There still is much work to be done and the AMA will be relentless in pursuit of the unfinished business of health system reform and empowering patients and physicians to improve the health of our nation.

Please stay tuned for further developments.

After careful review and consideration, the AMA announced its qualified support (PDF) today of passage of health system reform legislation under consideration in the U.S. House of Representatives. Passage would be another step forward in the journey to provide health care coverage for all Americans.

When H.R. 3590 was being considered in the U.S. Senate, the AMA supported its passage while expressing opposition to certain provisions that we believed could be resolved in the conference committee process. We worked hard and made significant progress toward resolving those issues before the conference negotiations ended. There are still issues in H.R. 3590 that cannot be addressed through the current reconciliation process and will need to be addressed by Congress and the administration.

By extending coverage to the vast majority of the uninsured, improving competition and choice in the insurance marketplace, promoting prevention and wellness, reducing administrative burdens, and promoting clinical comparative effectiveness research, the AMA believes that H.R. 3590 does, in fact, improve the ability of patients and their physicians to achieve better health outcomes.

The pending bill is an imperfect product but passage of H.R. 3590 marks an important step toward improving the health of the American people. Our work is far from done and additional congressional action is needed to address outstanding issues. The AMA will be relentless in its pursuit of these important policy adjustments and will work with the administration on the next steps to strengthen our health care system.

The House is expected to vote on the health system reform bill on Sunday, March 21. Stay tuned for further updates on H.R. 3590.

This afternoon (March 15), the House Budget Committee will begin consideration of a reconciliation bill that will carry refinements to H.R. 3590, the Senate-passed health system reform legislation. The Budget Committee is scheduled to begin meeting at 3:00 pm and plans to stay in session until midnight.

A 2,300 page bill has been posted on the Budget Committee web site. Importantly, this bill is NOT the vehicle that House leaders intend to bring to the floor. The language contained in this “shell” vehicle will ultimately be stripped out and replaced with new legislative language that is not yet available for review. We do not expect the true reconciliation bill language to be released before Tuesday.

Following the Budget Committee’s action, the House Rules Committee will meet later this week and insert the final language into the bill before it is brought to the House floor for a vote. The floor vote is not expected to take place until the end of the week, perhaps on Friday or Saturday.

We will keep you informed as the process unfolds.

Sometimes the task seems daunting, especially when you know there are 46 million uninsured people in our country, and their ranks are growing every day; that patients and their doctors have to fight with insurers to approve treatment, and then fight again for payment; and that dedicated doctors are driven from the profession by the burdens of bureaucracy, astronomical medical liability premiums and payments that fail to cover practice costs.

But with great challenges come great opportunities. We need reforms that will:

1. Maintain the relationship between patients and their doctors;
2. Expand coverage to all Americans through a choice of plans;
3. Repeal the flawed Medicare physician payment system that harms seniors’ access to care;
4. Curb insurance industry practices that frustrate patients—and their doctors!

Use our Patients’ Action Hotline at (888) 434-6200 to call Congress. Or Take Action here.