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House GOP, Democrats reach bipartisan Medicare deal

Melissa Nann Burke
Detroit News Washington Bureau

Washington – — Committee leaders in the U.S. House on Tuesday agreed to a bipartisan deal that would permanently revise the Medicare formula used to calculate payments to doctors and fund two health programs for at-risk individuals.

U.S. Reps. Fred Upton, R-St. Joseph, and Sander Levin, D-Royal Oak, are among the sponsors of the bill to fix what’s known as the Medicare Sustainable Growth Rate. The current formula expires at month’s end, after which Medicare providers would face a 21-percent cut to payments.

“We can see the light at the end of the SGR tunnel – finally,” said Upton, chairman of the House Energy and Commerce Committee, which released the package ahead of a floor vote expected Thursday.

“This responsible legislative package reflects years of bipartisan work, is a good deal for seniors, and a good deal for children, too.”

Levin noted the bill includes a two-year extension of the Children’s Health Insurance Program, which runs out of funding Sept. 30. Another provision would fund community health centers.

Michigan has 35 “federally qualified” health centers providing medical care at roughly 240 clinic sites across the state — mostly rural outposts and urban neighborhoods with high levels of poverty and a scarcity of primary care physicians.

“This legislation provides a real opportunity to create stability for seniors and doctors by doing away with the flawed SGR system and replacing it with one that rewards quality and innovation,” said Levin, ranking member of the House Ways and Means Committee.

The cost is estimated at more than $200 billion, with about $70 billion of that offset by spending cuts, including higher premiums for some high-income seniors. The bill would streamline three Medicare fee-for-service programs into one and offer incentives to providers meeting performance thresholds. The bill includes a 0.5 percent payment increase for physicians during a transition period through 2019.

Speaking to reporters Tuesday morning, House Speaker John Boehner said the chamber is going to make the “first real structural entitlement reforms in nearly two decades.”

Senate Democrats are pushing for a four-year extension for Children’s Health Insurance Program, which covers more than 10 million children.

U.S. Sen. Debbie Stabenow, D-Lansing, signed a statement Saturday with 11 other Democrats on the Senate Finance Committee expressing concern about specific provisions. Some senators worry about the proposed increased costs to some Medicare beneficiaries and the potential effect on women’s health services.

mburke@detroitnews.com