Allison And Pryor: Support SGR Repeal, CHIP Extension

This is a joint article by Joel Allison and Dr. Bob Pryor

The U.S. Senate is on the verge of approving two measures critical to American healthcare—one impacting seniors, the other impacting underprivileged children.

Approximately 3 million baby boomers are entering retirement and enrolling in the Medicare program each year. By 2029, an estimated 20 percent of the American population will be Medicare-eligible. But will they be able to find physicians who accept it?

Ending the Sustainable Growth Rate is now up for vote when the Senate reconvenes on April 13. Unless it’s repealed, physicians will see their fees for Medicare reimbursement cut by 21 percent. This decision would not only discourage new physicians from accepting Medicare patients, it would force some current physicians to abandon the Medicare patients they see today.

The SGR originally was designed to control the costs that the Medicare program paid to doctors if those costs were growing faster than the economy. Though it cut fees once in 2002, Congress has postponed additional cuts 18 times since then, causing the rate to accumulate to the 21 percent physicians now face. At this size, practices will have increased pressure to stay in business and many may choose to exit the program altogether. Many physicians have been reluctant to make investments in their practices because of the uncertainty over the SGR and Medicare reimbursement. Repealing the SGR is vital to ensuring access to healthcare for millions of American seniors.

Also now in the hands of the Senate is a proposed extension of the Children’s Health Insurance Program (CHIP). If not passed, funding for this critical program will end in September.

In Texas, a child living in a family of four earning less than $48,500 annually is eligible for CHIP. Since its start, the program has helped nearly one million young Texans gain access to the health care system, helping to lower the uninsured rate for the state’s children by more than 20 percent.

We know uninsured children are not only less likely to have their health needs met; they are far less likely to get valuable preventative care. Research also shows uninsured children will struggle to obtain better health as adults and it will limit their ability to achieve higher levels of education and higher tax revenues. If the Senate chooses not to extend CHIP funding, an estimated one-in-three children covered today would become uninsured.

As healthcare leaders and as Texans, we strongly encourage our senators to support the passage of these important pieces of legislation.

Joel Allison is the CEO of Baylor Scott & White Health. Dr. Bob Pryor is the system’s chief medical officer, and formerly served as the CEO of Scott & White prior to its merger with the Baylor Health Care System.

Posted in Expert Opinions.