“Funding a fix is crucial. Last year, the Medicare actuaries estimated that the 75-year cost of an unfunded Medicare doc fix would add another to $2.3 trillion to the already enormous unfunded liabilities of the Medicare program.
“Now, the alarming news. According to Politico Pro, staff level negotiations in the House of Representatives are focused on paying for a relatively small portion of the doc fix, saddling taxpayers with tens of billions of dollars — in extra obligations. Worse, the report advises, the negotiators plan to rationalize not finding offsets by arguing that the SGR was just a “budgetary gimmick” anyway. Such a combination of cynicism and fiscal irresponsibility, if it came to pass, would be breathtaking.”
“In total, now, lawmakers have offset 132 out of 135 months of doc fixes since 2004 with equivalent savings, or 98 percent of the time. Even disregarding the few times small gimmicks were used, policymakers still paid for these delays 94 percent of the time – with almost all of those savings coming from health care programs.
“Although the SGR clearly has not functioned as intended, it has served as an action forcing mechanism to prompt targeted health reforms in place of its prescribed blunt, across-the-board cuts.
“Lawmakers should go further than the current discussions and pay for the entire package, not just a small portion.”
“[S]uccumbing to [this deal] would set back the cause of long-term fiscal reform. To repeat, the sustainable growth rate has not quite worked as intended, but at least its failure never turned into a source of higher deficits. Instead, both parties should treat this as a chance to impose more structural changes, over and above the $37 billion worth contemplated. The Committee for a Responsible Federal Budget has identified $215 billion worth of medical program savings that could help pay for a long-term doc fix without altering eligibility or other fundamentals in either Medicare and Medicaid.
“For all the polarization and partisanship of a dysfunctional Congress, Republicans and Democrats have proven many times that they are still capable of agreeing to spend more on entitlements and pay for it through borrowing. They should miss this opportunity to prove that yet again.”