AAMC/grr Update

On Tuesday, Senate Budget Committee Chair Patty Murray (D-Wash.) and House Budget Committee Chair Paul Ryan (R-Wis.) announced a bipartisan agreement to provide partial relief from sequestration in FYs 2014 and 2015 and to avoid another shutdown of the federal government.

The Bipartisan Budget Act of 2013 authorizes an increase in discretionary spending for FYs 2014 and 2015. The revisions for defense discretionary and non-defense discretionary spending are shown below.

The budget agreement only sets the top-line spending cap.  Appropriators will still need to determine funding levels for specific programs. The budget agreement does not include any specific provisions related to medical research or NIH.

The companion Pathway for SGR Reform Act includes several important health care related provisions including: a three-month Medicare physician payment patch that prevents a 20.1 percent physician payment cut due January 1, increasing Medicare physician reimbursement by 0.5 percent through March 2014; and a provision delaying the scheduled 2014-15 Medicaid DSH cuts until 2016. However, the AAMC is deeply disappointed by the sudden removal of the “Two Midnight Rule” delay and remains extremely concerned about provisions that would extend the Medicare sequester through 2023 and rebase Medicaid DSH payments in 2023.

The AAMC supports the budget agreement and Medicare/Medicaid package and is sending the attached letter to all members of Congress urging passage.  President Obama has signaled he will sign the bill.

The House Rules Committee met today on the budget agreement and Medicare/Medicaid package.  Both are being offered as amendments to H.J. Res. 59, the original FY 2014 CR that passed the House but was never finalized. The House may vote on the budget agreement as early as Thursday, Dec. 12.

Here are links to a summary of the budget agreement, text of the amendments, and section by section analysis of the amendments:

• Summary of the Bipartisan Budget Act of 2013 bba2013summary.pdf
• Legislative text of Bipartisan Budget Act BipartisanBudgetActFINAL.pdf
• Section by section analysis of Bipartisan Budget Act Section-by-Section-FINAL.pdf
• Legislative text of the Pathway for SGR Reform Act Pathway for SGR Reform Act.pdf
• Section by section analysis of the Pathway for SGR Reform Act Section by section analysis of Pathway to SGR Reform Act.pdf