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Congressional ‘freeze’ begins to thaw

Dear CareOregonians:

Greetings from the East Coast! As you celebrate 20 years of serving Oregonians, things in Washington, D.C. are starting to thaw from a very snowy winter. I want to provide a brief update on what is happening with our federal Medicaid and Medicare programs. 

Emily Katz, CareOregon government relations consultant
Emily Katz

One piece of news you may have heard about is that Oregon’s senior senator, Ron Wyden, is now the chairman of the Senate Finance Committee. The committee has jurisdiction over Medicaid and Medicare budget and policy, and Sen. Wyden’s position is widely considered one of the most powerful in Congress. He is known for working across the aisle to accomplish large policy goals in a bipartisan manner.

Emily Katz is a previous CareOregon employee who worked in the Public Policy Department for many years.  She now owns an independent consulting business and works with CareOregon to track and influence federal policy for Medicare, Medicaid and Oregon's Health CO-OP.

In that vein, Sen. Wyden recently released new bipartisan legislation attempting to overhaul the Medicare program and focus more dollars on managing chronic illness. In his new position, it’s possible the senator will lead some major policy changes to Medicare in the coming years. CareOregon will serve as an excellent home state example for the senator, and the work CareOregon currently does with his office will only continue to build.

Meanwhile, the Senate Finance Committee is poised to overhaul the formula for physician payments from Medicare, known as the Sustainable Growth Rate (SGR). The SGR formula currently is used to calculate physician pay. However, it only has been used to increase physician pay, never decrease it. This practice has created a situation that may necessitate massive pay cuts to physicians. Right now, both parties in the House and the Senate are in intense negotiations over how to permanently repeal and replace the SGR with a payment system that rewards quality over quantity and will encourage alternative payment models to the fee-for-service model. However, there is no agreement on a way to pay for the change. As a result, we may continue to see stop-gap measures taken to prevent provider pay cuts.

Also expect fights over the Affordable Care Act to continue this year, especially as mid-term elections draw closer this November.

You are welcome to reach me at if you have a question, or simply want to say hello!

Congratulations again on 20 amazing years!