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Without Way to Pay for SGR Repeal, Is Optimism in Vain?

Jacqueline Fellows, for HealthLeaders Media, December 5, 2013

The AMA stays strictly "on the policy side" of things, though Hoven admits the fiscal question of how to pay for the SGR repeal is significant and consistent.

"We hear this every time we visit with members of Congress," she says.

One plan that Perez believes is a realistic possibility is the Medicare Drug Savings Act sponsored by Sen. Jay Rockefeller (D-WV) who is also a member of the Senate Finance committee, which will be marking up the SGR repeal bill next week.

Rockefeller's bill extends discounted drug pricing to the dual-eligible population, saving an estimated $141 billion over 10 years. That makes the SGR fix more than budget-neutral. To drum up backing for the bill, Rockefeller sent letters (PDF) to 65 hospital, physician, and provider groups in November asking for their support.

But the AMA and other groups run the risk of weakening their Congressional clout if they take sides on a bill paying for the SGR, such as Rockefeller's. His bill has zero support among Republicans and is opposed by the powerful pharmaceuticals lobby.

Perez describes the juxtaposition of bipartisanship on a single issue in a session marked by partisan politics as "a day of reckoning" for the SGR.

"If you have Republican and Democratic agreement on the SGR, then the question is, 'Are the Republicans so in favor of that [that] they're willing to go along with a Democratic bill?'"

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