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Yesterday, as part of a first-of-its-kind hearing on Medicare for All, the American Society of Anesthesiologists (ASA) submitted a formal Statement for the Record to the Committee on Rules expressing concerns about the legislation’s impact on the practices of anesthesia services. The hearing on H.R. 1384, the “Medicare for All Act of 2019”, before the House Committee on Rules focused on a proposal to transform the health care system of the United States into a government-run single payer health program.
The main sponsor of the bill is Rep. Pramila Jayapal (D-WA-7) and the bill is co-sponsored by over 100 House Democrats. Sen. Bernie Sanders (VT-I) is the sponsor of the Senate version of similar legislation, S. 1129, “Medicare for All Act of 2019.” As part of ASA’s statement, concerns were raised regarding the unsustainable payment model for anesthesiology practitioners and other providers. For most services, commercial payers subsidize inadequate Medicare payments. Nowhere is this truer than with Medicare payments for anesthesia services; Medicare payments for services of physician anesthesiologists have long been plagued by inequality and instability. The Medicare “33% problem” has been a persistent challenge by paying anesthesia services at only 33% of private pay rates, the lowest rate among all health professionals, while Medicare payments for other physician services are approximately 75% of commercial pay rates.
ASA urges open dialogue and stakeholder discussion to ensure the right policy approach is taken to improve access to health care for all Americans. While ASA recognizes the legislation being considered is one approach that may provide insurance coverage for all Americans, ASA believes the legislation would have negative impacts on the adequacy and robustness of the coverage itself. Any health care system that builds provider payment off historic Medicare payments rates is unsustainable and will significantly compromise the availability of adequate care for patients, particularly those who need anesthesia services.
House Speaker Nancy Pelosi (D-CA) has urged a cautious approach to the new House Democratic Majority, indicating a preference for improving and strengthening provisions of the Affordable Care Act, and questioning the budget impacts of the Medicare for All legislation. The legislation is not expected to advance in House, nor in the Republican-controlled Senate and White House, where it faces steep opposition.
ASA will continue to monitor this and other health care related legislation. Members of the American Society of Anesthesiologists (ASA) Executive Committee (EC) and ASA Advocacy staff continue to meet with key Committees and House and Senate leadership staff to discuss concerns with this proposal.
Read the text of the bill, H.R. 1384 here.
