"It will be important to remember why there was a problem in the first place," Cooper wrote in an email exchange with HealthLeaders Media. "The SGR was predicated on the belief that the growth of medical spending could be held to the overall U.S. economic growth rate. This was applied specifically to the physician portion, but there is no reason to think that it would be different from the rest. And after 15 years, we see the result of faulty logic. It will be important not to engraft that logic into current reform efforts. Healthcare spending grows more rapidly than the economy overall. To plan differently will be to repeat the pain caused by the SGR."
Gilberg says that even with the lowered cost projections, finding $138 billion in the midst of ongoing budget battles would be no small feat. "The impetus exists in a larger package, not in isolation," he says.
"Will $138 billion materialize out of nowhere in this environment to pass this bill? No. But if there is growing support for repealing SGR along the lines of what was outlined here, then could it realistically exist in some larger package? I certainly wouldn't write it off. I think it is serious. That CBO score is a pretty big catalyst that didn't exist ever before."