May 22, 2018
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Congressional delays threaten health care for Mainers

By Peter Carmel, Special to the BDN

Congress has been procrastinating on an action that is critical to protect health care access for seniors and military families in Maine and across our country. It has put off getting rid of the broken Medicare physician payment formula, which threatens access to care for millions of Medicare and TRICARE patients by frequently threatening drastic cuts. If Congress does not act now, a 27 percent cut is scheduled to hit physicians who treat seniors and military families on March 1.

The looming cut would force many physicians to limit the number of Medicare and TRICARE patients they see in their practices. We’re already seeing some signs that seniors are having trouble accessing Medicare physicians. Twenty-two percent of Medicare patients looking for a new primary care physician had trouble finding one, according to a 2010 report from Congress’ Medicare advisory committee. A 27 percent cut on March 1 would make this much worse.

Preserving access to health care for seniors and military families in Maine is critical. Close to 20 percent of Maine’s population relies on Medicare or TRICARE for health care coverage. Compared to the rest of the country, this puts Maine at an above average proportion of Medicare patients. Yet, there are only 14 practicing physicians per 1,000 Medicare patients in Maine, which is below the national average.

Instead of stabilizing Medicare and TRICARE by fixing the problem, Congress has made it worse over the past decade by passing 13 costly, short-term patches that only delay the cuts. These short-term patches have increased the cost to taxpayers for permanent elimination of the formula from $48 billion in 2005 to $300 billion today.

If Congress continues to spend more money to keep this broken system in place, the cost will double again in five years to $600 billion. The scheduled cuts are becoming steeper and the cost to taxpayers greater the longer Congress stalls. The cost for Congress to fix this problem will never be less than it is right now.

In order to permanently eliminate this problem, Congress must work in a bipartisan fashion to get rid of the broken Medicare physician payment formula. This will protect access to care for seniors and military families and stop increasing the cost to taxpayers. It is the fiscally responsible way to stabilize the Medicare and TRICARE programs that nearly 300,000 people in Maine rely on.

There is a unique opportunity right now to use projected spending for the wars in Afghanistan and Iraq to eliminate the flawed formula and protect access to care for seniors and military families. As operations in Iraq and Afghanistan wind down, projected spending that won’t be used on the wars becomes available to ensure access to care for our military and seniors — without adding to the nation’s deficit. Passing up this opportunity would leave Congress with an even more costly problem to resolve in future years, requiring even more difficult choices.

Poll results show that 94 percent of Americans believe a cut, such as the 27 percent cut scheduled for March 1, is a serious problem for those who rely on Medicare. Patients, physicians and taxpayers need to make their voices heard. This month is critical for Medicare and TRICARE patients in Maine and across the country.

Now is the time to contact Maine’s members of Congress and tell them to eliminate this broken formula and preserve access to health care for seniors and military families. By accessing the AMA’s Patients’ Action Network at or calling 888-434-6200, you can learn more about this important issue and identify and contact your federal legislators. Please join us in telling Congress that the time for a permanent solution to this ongoing problem is now.

Peter W. Carmel, MD, a pediatric neurosurgeon who practices in Newark, N.J. is president of the American Medical Association.

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