Policy Solutions to the Border Crisis

Floor Speech

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Mr. BUCSHON. Mr. Speaker, I thank the gentleman for yielding.

I am rising today to advocate for America's patients and their physicians.

Over the past 3 years, doctors across the Nation have more than stepped up to the challenges that they have encountered, COVID, often risking their own health and safety to protect our communities. That not only includes the physicians; that includes the nurses, the technicians, and everyone in America's hospitals. However, when Congress left town in December, we once again let down America's doctors by allowing a 3.37 percent Medicare payment cut to hit January 1.

As a cardiothoracic surgeon for 15 years, I have seen firsthand the consequences of cuts like these. What are the consequences? Access to quality healthcare for rural America that I represent, underserved urban America, the American people.

The payment cut to physicians will impede patients' access to care while increasing the gap between physician expenses and reimbursement rates.

I want to associate myself with Dr. Murphy's comments. Costs are dramatically going up, and, if that continues, more and more of America's physicians will not take Medicare. I didn't say Medicaid. I said Medicare.

Given the existing shortage of physicians in the United States, the combination of declining reimbursement and rapidly rising costs threatens to drive more doctors out of the profession, particularly, as I mentioned, in rural and underserved urban America.

It has led to a lot of consolidation, as Dr. Murphy mentioned-- physicians being consolidated into a large medical practice or employed by large hospital systems.

Fortunately, we have a window of opportunity to right this wrong and support the thousands of hardworking men and women serving millions of Medicare beneficiaries. We must stop the bleeding and eliminate the full 3.37 cut by January 19.

Congress must also implement a permanent solution that will halt the downward spiral of physician reimbursement and provide much-needed and deserved stability for America's doctors. Again, if we want access for America's seniors to the Medicare program, we have to act. We have to act soon.

Again, it is not just physicians out there not taking Medicaid. They are not taking Medicare. I have elderly in-laws and an elderly mother. They have experienced this.

In fact, we had a hearing in the Committee on Energy and Commerce a couple of weeks ago. There was an economist there. He couched it in a way that was positive. He said, Well, 60 percent of America's seniors are not having trouble finding a primary care physician.

When it came around time for my questioning, I said, Well, I want to rephrase that. Forty percent of America's seniors are struggling to find a primary care doctor. That is a big number, folks. Forty percent of America's seniors are struggling. Their physician retires. Their physician moves. Trying to find a new primary care doctor is a big challenge. We cannot let this continue--again, urban America and underserved areas, rural America that I represent.

In 2023, for a more permanent solution, I introduced the bipartisan Strengthening Medicare for Patients and Providers Act, which would tie the annual physician fee schedule updates to inflationary measurements, the Medicare Economic Index, or MEI. That is both fair and efficient. It has been promoted. Almost every medical society in America thinks this is a good idea.

I don't have the graph in front of me but let me just tell you what it shows. Outpatient and inpatient hospital care gets an update based on inflation every year. Providers do not. As Dr. Murphy outlined, it has been at least a 20 percent cut just based on that in the most recent history, and even more if you factor in the massive inflation-- which thankfully is down--that we had last year and the year before.

The current path toward further consolidation, physician burnout, closure of medical practices must be corrected. If we don't correct this, the problems I outlined are going to continue.

I urge congressional leadership to address this critical issue, and I will continue to advance patient-centered solutions that empower patients and support innovation to ensure that all Americans have access to quality, affordable healthcare.

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