Last week, the bipartisan Congressional Budget Office (CBO) announced they had lowered their estimates on projected federal expenditures to reflect an overall reduction in healthcare spending. The CBO now projects that federal healthcare spending through 2023 will total $7.9 trillion. Although the figure is lower than the $8.1 trillion it predicted in February, the smaller figure remains significantly higher than the projected GDP.
Although a threat remains to reduce Medicare reimbursement rates, many primary care physicians are still waiting on a Medicaid payment increase guaranteed to them under the Affordable Care Act (ACA). The hold-up seems to be coming from states that have been resistant or unable to increase the dollars allotted to their respective Medicaid programs. Under the ACA, the payment increase is to come from matching funds from the federal and state governments. However, while primary care physicians stand to benefit, the payment bump would not apply to emergency physicians.
An article in the Annals of Emergency Medicine “finds that national expenditures on emergency care are likely significantly higher than previously thought.” While the Agency for Healthcare Research and Quality (AHRQ) has long stood by its claim that only 2 percent of healthcare spending goes towards emergency medical care, the report’s authors believe the actual figure could be as high as 10 percent. This realization would certainly undermine many of the efforts being adopted to reduce overall spending. Although, as Myles Riner, MD, writes, “How much is the nation spending on ER Care? Wrong Question”.
Lastly, as details emerge about the recent controversy with the IRS, questions emerge as to how this may affect the implementation of the ACA. Because the IRS will play a key role in certain aspects of the ACA, this relationship is coming under scrutiny. In fact, a report says that the person who oversaw the tax-exempt organizations at the IRS during that time now has a key role with the IRS healthcare section.