Physician Leaders Disapprove of Lawmakers’ Decision to Link Medicare Payment Reform to Delay in ACA Mandate

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ACPE Poll Finds More Than 80 Percent Say the Two Measures Should Not Be Connected

An overwhelming majority of physician leaders believe the U.S. House of Representatives made a mistake when it linked an important initiative for Medicare reimbursement reform to a delay in the ACA’s mandate that individuals purchase health insurance, according to a new poll released by the American College of Physician Executives (ACPE).

The poll showed 80 percent of respondents did not believe repeal of the Sustainable Growth Rate (SGR) should be tied to a delay in the individual mandate of the Accountable Care Act. An additional 16 percent said they should be linked, while 3 percent were unsure.

“Repealing the outdated and ineffective SGR is not a partisan issue – it’s what’s best for health care,” said Peter Angood, MD, FRCS(C), FACS, FCCM, President and CEO of ACPE. “The poll results reflect the frustration many of our members feel after 17 years of short-term fixes. I believe we all feel strongly it’s time for a more permanent solution to our country’s Medicare funding challenges.”

At the urging of physicians and physician leaders, a bipartisan group of lawmakers earlier this year created a bill that would repeal the SGR, which was created in 1997 as a means of controlling Medicare spending by linking it to the country’s economic growth rate.

House Republicans added a last-minute provision that would offset the cost by delaying the ACA’s individual mandate until 2019. The move deeply divided Republicans and Democrats, which means the bill is not likely to pass the Democratic-controlled Senate. The White House has also threatened to veto the measure.

The poll was delivered via email to ACPE members and 551 responded as of March 24. Participants were also invited to share their comments on the topic.

Most of those who responded said repeal of the SGR had nothing to do with the individual mandate and they should not be connected.

“Both important issues but hate to see them leveraged one against the other,” wrote Mark Browne, MD, MMM, FAAP, FACPE, a member of the ACPE Board of Directors. “The SGR needs to be fixed...period. Keep all of the distractions out of the discussion.”

Several members said they were frustrated by House Republicans for allowing political gamesmanship to threaten the passage of such an important measure.

“Trying to score political points while correcting a long-standing problem doesn't make sense,” said Carroll Labron Chambers, MD. “The ACA may need tweaking, but that is not intrinsically linked to repeal of the SGR.”

But others said they were disappointed with Democrats and the White House. They pointed out that the Obama administration has already delayed the individual mandate for people whose insurance plans were canceled, so why allow it to derail the elimination of SGR?

The poll results come as hope fades on Capitol Hill for finding a permanent solution to fix Medicare reimbursement. Lawmakers are now talking about passing yet another temporary patch, which they have done repeatedly throughout the 17-year history of the SGR.

Several ACPE members said the situation illustrates why physician leaders need to take a more active role in reforming health care.

“Let's abandon the Congressional rhetoric contest and improve our health care system now,” wrote Glenn Mitchell, MD, MPH, FACEP. “They both need fixing and they both need it soonest.”

To view the full poll results, visit

About ACPE: ACPE is the nation’s oldest and largest medical association that is solely focused on leadership education and management training for physicians. The organization has educated nearly 100,000 physicians and represents more than 11,000 high-level physician leaders from health care organizations across the U.S. and in over 45 different countries.

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Carrie Johnson
American College of Physician Executives
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