The effort to permanently eliminate the SGR in the 114th Congress took a major step forward on March 19, 2015, when Congressman Michael Burgess, MD (R-TX) along with bipartisan members of the House Committees on Ways and Means and Energy and Commerce, as well as Senate Finance Committee Chairman Orrin Hatch (R-UT), introduced H.R. 1470/S. 810, the SGR Repeal and Medicare Provider Payment Modernization Act of 2015. With the exception of changes to key dates and the imaging appropriateness criteria section which was already enacted in March 2014, this bipartisan, bicameral SGR repeal bill was essentially identical to the policy introduced in the 113th Congress.
Introduction of H.R. 1470/S. 810 preceded the historic announcement by then House Speaker John Boehner (R-OH) and Minority Leader Nancy Pelosi (D-CA) that Republicans and Democrats agreed to a package of policy changes that would cover close to one-third of the approximately 10-year, $200 billion total cost of repealing this antiquated system of reimbursing physicians for treating Medicare patients. The deal reached by House Republican and Democratic leaders utilized a combination of more stringent means testing for wealthy Medicare beneficiaries, limits on the ability of Medicare Supplement Insurance (“Medigap”) plans to offer first-dollar coverage for patients, as well as additional cuts to hospitals and post-acute providers to offset the cost of repealing the SGR. In addition, Speaker Boehner and Minority Leader Pelosi elected to use the same policy agreement to reauthorize the popular state children’s health insurance program, commonly referred to as SCHIP, for an additional two years.
As a result, on Tuesday, March 24, 2015, the House introduced a new bill, H.R. 2, the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA), which was ultimately passed by an overwhelming bipartisan majority (392 Ayes and 37 Nays) on March 26, 2015. H.R. 2 incorporated all of the legislative language found in H.R. 1470, as well as the additional policy provisions agreed to by then Speaker Boehner and Minority Leader Pelosi. The Senate also passed the legislation with a large bipartisan majority (92 Ayes to 8 nays) on April 14, 2015. President Obama ultimately signed H.R. 2 into law on April 16, 2015.