Mr. Speaker, I thank the gentleman from Missouri for yielding. Mr. Speaker, we are hearing that this bill is a tax cut. But that only applies if you sign up for ObamaCare and participate in all the green tax credits. But if you don't, then…
Mr. Speaker, I thank the gentleman from Missouri for yielding.
Mr. Speaker, we are hearing that this bill is a tax cut. But that only applies if you sign up for ObamaCare and participate in all the green tax credits. But if you don't, then this bill is a tax increase of over $10.5 billion for those making under $200,000 a year.
Despite what you say, there is $80 billion in this bill for 87,000 new IRS agents, and this will disproportionately increase audits on low- and middle-income earners at a time when even the best CPA firms cannot find qualified employees.
Now, Wednesday in the Rules Committee, I tried to get an amendment by Mr. Davidson of Ohio made in order that would require that all of these new hires at least be CPAs. This was rejected by every Democrat in the Rules Committee.
Mr. Speaker, they are coming after you. They are coming after you with poorly trained technicians, and it is just not right.
Madam Speaker, I thank the gentleman from Kentucky for yielding.
Madam Speaker, I include in the Record a letter submitted by the members of the House GOP Doctors Caucus.
Congress of the United States,
House of Representatives,
Washington, DC, August 6, 2022.
Hon. Chuck Schumer,
Majority Leader, U.S. Senate,
Washington, DC.
Hon. Nancy Pelosi,
Speaker of the House, House of Representatives,
Washington, DC.
Dear Leader Schumer and Speaker Pelosi: We write to express
our strong opposition to the government drug price control
policies in your reconciliation package. As medical providers
and Members of Congress, we are deeply concerned with the
harm these provisions will cause to patients across the
country.
The GOP Doctors Caucus has continuously worked to ensure
that physician practices can stay open to continue treating
patients. We have heard directly from providers that the cuts
proposed in this bill will jeopardize patient access to care.
According to Avalere, changes to the Medicare Part B
physician-administered drug reimbursement would lead to an
average cut of 39.8 percent for health care providers. The
confluence of these cuts, including the 0 percent payment
update, the reduction of the 4.5 percent Medicare conversion
factor, and the adoption of several changes to the Evaluation
and Management (E/M) Current Procedural Terminology codes,
threatens the sustainability of medical practices and will
lead to physicians closing their doors.
It is irresponsible to divert seniors' Medicare dollars to
pay subsidies to non-Medicare insurance companies, yet this
plan would do just that. The proposal will take ``savings''
from the drug price controls in the Medicare program to pay
for expanded health insurance subsidies under the Affordable
Care Act (ACA). This is money going to insurance companies
and their bottom line; this is not money going directly
towards care in any way. These expanded subsidies were
originally part of the inflation-creating American Rescue
Plan Act (ARPA). ARPA removed the income cap restricting
access to premium tax credits, opening the door to taxpayer-
funded subsidies for some of the wealthiest Americans. Some
families making more than $500,000 annually now have access
to expanded ACA subsidies, and they will continue to if this
proposal goes through. Robbing Medicare to enhance the profit
for insurance company shareholders and executives does
nothing to improve anyone's health. To us, this is
unconscionable.
If this plan is passed into law, millions of patients could
die waiting for new drugs and cures that will no longer be
developed in their lifetime. Government price controls have
consequences. The Congressional Budget Office has
conservatively estimated that 15 fewer drugs will be
developed over the next 30 years under this bill, Another
study found that only six out of 11 currently approved
therapies would have been brought to the market if this
framework were in place.
Any cure lost is one too many. As Members of Congress who
have been involved in patient care, we understand the real-
world impact that this will have on patients. Many of us have
treated patients with chronic and life-threatening diseases.
We've seen expensive surgeries and intensive inpatient care
be eliminated by the development of new therapies. This
development and innovation will all but go away, leaving
patients without hope for improved quality of life and long-
term savings.
We remain concerned that this proposal will also put the
government in control of Americans' medical decisions. This
is another clear example of a policy crafted by politicians
who have never seen a patient. The bill calls for a 95
percent excise tax if drug companies do not accept the price
government bureaucrats put in place. Top down, ``take it or
leave it'' government price negotiation isn't a negotiation
at all--it's government price fixing.
This reconciliation package under consideration applies
upward pressure on drug pricing. The bill subjects a company
to negotiation once its seven-year exclusivity expires. As a
result, companies could introduce drugs into the marketplace
with high list prices, causing premium increases for
healthier individuals enrolled in employer-sponsored plans.
In summary, this reconciliation package will have grave
consequences for patients and patient care:
This price setting scheme put forth in this bill will
endanger patient access to care by cutting provider
reimbursement on impacted Part B drugs by an average of forty
percent.
The bill does nothing to address other ongoing Medicare
provider payment cuts set to begin in 2023.
If this plan is passed into law, millions of patients could
die waiting for new drugs and cures that will no longer be
developed in their lifetime.
Government price controls have consequences, and one lost
cure is one too many.
This plan robs Medicare to pay subsidies to insurance
companies and other non-health related expenditures.
As medical providers in Congress, we urge you to recognize
the danger this proposal will have on patients. We can and
should work on a bipartisan basis to lower drug costs without
sacrificing the cures and treatments that will provide for a
healthier future.
Sincerely,
Brad R. Wenstrup, D.P.M., Member of Congress; --Andy
Harris, M.D., Member of Congress; ----Roger W.
Marshall, M.D., United States Senator; --Rand Paul,
M.D., United States Senator; ---Larry Bucshon, M.D.,
Member of Congress; ---Neal P. Dunn, M.D., Member of
Congress; ---Michael C. Burgess, M.D., Member of
Congress; Bill Cassidy, M.D., United States Senator;
John Barrasso, M.D., United States Senator; John
Boozman, M.D., United States Senator; Earl L. ``Buddy''
Carter, R.Ph., Member of Congress; Brian Babin, D.D.S.,
Member of Congress.
A. Drew Ferguson, IV, D.M.D, Member of Congress; --Scott
DesJarlais, M.D., Member of Congress; ---Ronny L.
Jackson, M.D., Member of Congress; ---Gregory F.
Murphy, M.D., Member of Congress; ---Mark E. Green,
M.D., Member of Congress; ---John Joyce, M.D., Member
of Congress; Jefferson Van Drew, D.M.D., Member of
Congress; Mariannette J. Miller-Meeks, M.D., Member of
Congress; Diana Harshbarger, Pharm. D., Member of
Congress.
Madam Speaker, this is a letter that explains how healthcare policies included in the Inflation Reduction Act would affect American patients. There are 21 healthcare professionals who signed this letter.
It is remarkable that none of our concerns were considered--all were ignored--not only as Members of the House and Senate but as healthcare professionals, as well.
The point of the letter is that this legislation will do the exact opposite of what the Democrats intend. Unfortunately, the legislation will kill research and development, reduce quality of care, and threaten patient access to lifesaving drugs.
Under this legislation, we are going to see changes to part B drug reimbursements that will lead to an average of a 40 percent cut for healthcare providers, doctors who provide care to Medicare patients in their offices.
Currently, part B reimbursements for administering drugs in a physician's office are a calculation based on the average sales price plus 6 percent. Under this new system, part B payments to physicians are going to be calculated off of the maximum fair price. It is an attractive term, but no one knows what it means. It is yet to be determined by whom? The Secretary of Health and Human Services. We have all seen how trustworthy they have been over the past 2 years.
The current 6 percent average sales price add-on payments to physicians, which is what doctors have come to rely on now to run their practices, will be based on a significantly lower government-set price versus the traditional market-priced ASP. This results in significantly lower payments to physicians.
Now, Wednesday afternoon late, at the Committee on Rules, I offered an amendment with Dr. Murphy to fix this problem. Unfortunately, that was rejected on a party-line vote.
These payment cuts threaten the sustainability of medical practices and will lead--let me say that again--will lead to physicians closing their doors. When practices close, the patient need does not disappear. Care will then shift to hospitals.
This will ultimately lead to an increase in healthcare costs and a decrease in the quality of care provided, and it will limit access to treatments for patients across the country.
From experience working in private practice, I can attest that there are significant consequences of consolidation. Here is the bottom line: Democrats are using Medicare as a piggy bank to pay for other things. What
other things? Oh, like subsidies to insurance companies. They want to reward insurance companies and punish doctors. It makes no sense.
This legislation will do the exact opposite of what Democrats intend. It is going to kill research and development. It is going to reduce the quality of care. It is going to threaten patient access to lifesaving drugs.
As the most senior doctor in Congress and someone who deeply cares about the well-being of American patients, this bill is antidoctor and antipatient. We will live to see the consequences of this after final passage, I promise you that.