A $1 trillion, bipartisan infrastructure bill passed the Senate on August 10 after months of negotiations, but associations representing physicians and other medical groups have taken issue with plans to use cuts to Medicare to partially pay for the legislation.

The CAP has tracked the legislation—which focuses on transportation, electric, broadband, and other infrastructure—throughout its development. To pay for new spending in the bill, lawmakers plan to utilize a variety of offsets, including a handful of health care-related provisions. According to the Congressional Budget Office and an analysis by the Committee for a Responsible Federal Budget, the legislation extends a mandatory budget sequester that affects the Medicare program. The extension of the sequester amounts to $9 billion.

Congress is expected to address several Medicare issues through the budget reconciliation process after elected officials return from the August recess. The CAP will be actively lobbying the Congress throughout this process on a number of issues impacting pathology.

To protect the value of pathology services, the CAP has lobbied against Medicare cuts to services provided to patients. During the CAP’s Hill Day in May, a record number of pathologists spoke with congressional offices to urge members of the House and Senate to stop future cuts to pathology services.

AMA: Medicare Cuts Destabilize Patient Care

In July, the American Medical Association (AMA) told lawmakers to “wake up” and recognize the state of financial peril in the Medicare program before using cuts to the program to pay for parts of the infrastructure package. In a letter to House and Senate leaders, the AMA expressed “deepening alarm” over the financial instability of the Medicare program.

“The AMA strongly urges Congress not to divert increasingly scarce health care dollars for non-health care purposes, especially when there are so many uncertainties and current policies are already undermining the Medicare physician payment system,” the AMA said.

The AMA listed the following stack of Medicare cuts, totaling 9.75%, set to take effect on January 1:

• Expiration of a reprieve from a 2% budget sequester.
• Imposition of a 4% statutory sequester stemming from the passage of the American Rescue Plan Act for at least 10 years.
• Expiration of congressional enacted 3.75% increase in the Medicare physician fee schedule to prevent budget neutrality adjustments stemming from increases to evaluation and management services.
• Implementation of a freeze in annual Medicare fee schedule updates through 2026, after which positive updates of 0.25% will be made indefinitely.

The CAP will continue to track the infrastructure bill as it moves to the House of Representatives for consideration.