PORTLAND – Maine’s seniors rely on Medicare for their health care coverage, but their access to and choice of physicians is now in serious jeopardy because of an impending steep cut to the physicians who care for them.

Unless Congress acts, on June 1, Maine physicians will be hit with a 21 percent payment cut for the care of seniors, forcing many to make difficult decisions about treating Medicare patients.

In fact, a recent informal AMA poll found that 68 percent of physicians nationwide say they will be forced to limit their care for Medicare patients in the wake of this year’s cut. Care for military families is also at risk, as their government health insurance program, Tricare, ties its payment rates to Medicare.

Consider Maine’s own situation: the state has an exceptionally high percentage of Medicare patients (17 percent) compared to the rest of the country and a below average ratio of physicians to Medicare patients.

At the same time, 47 percent of Maine’s practicing physicians are over age 50 — the age at which many physicians consider reducing patient care.

Couple these facts with the looming 21 percent cut, and access and choice of physician will be greatly diminished for the more than 271,000 seniors, disabled and military families in Maine who rely on government health insurance programs.

Already, about one in four seniors nationwide looking for a new primary care physician has trouble finding one, according to Congress’ advisory body for Medicare.

This doesn’t even take into account the fast-approaching wave of baby boomers who begin aging into Medicare next year.

Only the U.S. Congress can stop this imminent Medicare meltdown. Reform of the broken payment formula that creates this whopping cut will preserve access to care for Maine’s Medicare and Tricare patients.

This is the only way to fix the problem once and for all before the baby boomers begin to use Medicare in droves.

Congress’ prior efforts to stop annual cuts used budgeting gimmicks that have increased the size of future cuts and the cost of a permanent fix.

Each time Congress slapped another Band-Aid on the annual cut, they passed the buck to the next Congress.

The numbers tell the story in stark terms: In 2005, physicians faced a cut of about 3 percent and the cost of permanent reform was $49 billion. This year, the cut has reached a staggering 21 percent and the cost of reform has more than quadrupled to over $210 billion.

More delays will continue to pile debt onto the backs of taxpayers, and erode Medicare’s physician foundation as more doctors decide they can no longer care for Medicare patients if they want to keep their practice doors open.

There have been ample opportunities for Congress to repeal the payment formula and ensure the security and stability of Medicare and Tricare, but each opportunity has been squandered.

This is despite the fact that a bipartisan majority of Congress says the payment formula is flawed and must be fixed. Both AARP and the Military Officers Association of America agree.

Enough is enough. Now that Congress has made new coverage promises to the American public through health system reform, it’s more important than ever that they make good on the commitments they’ve already made.

Congress must act now to reform the broken Medicare payment formula and preserve the security and stability of health care for Maine’s seniors and military families.


– Special to the Press Herald


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