Democratic Physician House Members Launch Congressional Doctors Caucus

By Joyce Frieden

Six Democratic physician members of Congress are forming the Congressional Doctors Caucus, a group aimed at addressing a variety of healthcare concerns from potential Medicaid cuts to the reduction in the Medicare Physician Fee Schedule.

"For a long time, there were only two Democratic doctors in Congress: myself and [Rep.] Raul Ruiz, [MD]," Rep. Ami Bera, MD (D-Calif.) told MedPage Today in an interview Friday, the day the group was launched. Republican physicians in Congress -- of which there are many more -- "have their own GOP Doctors Caucus. They certainly would invite us to participate in some of their events, but often on policy issues -- whether it's protecting the Affordable Care Act or reproductive rights -- we have policy differences at times. Now that we've actually got six Democratic doctors, it was important for us to get our own doctors' caucus."

In addition to Bera and Ruiz, the other members of the caucus include Rep. Kim Schrier, MD (D-Wash.), Rep. Herb Conaway, MD (D-N.J.), Rep. Maxine Dexter, MD (D-Ore.), and Rep. Kelly Morrison, MD (D-Minn.). Bera noted that the group calls itself the "Congressional" Doctors Caucus and not the "Democratic" Doctors Caucus because "we think it's important to take partisanship out of the name.... Obviously, there are times where all the doctors in Congress can come together; the Medicare Physician Fee Schedule is probably one of those areas. Surprise billing is another area where we're able to come together, and we're hopeful that we can all come together to protect Medicaid, because that is such a vital way that so many Americans get their healthcare."

The Medicaid issue is top of mind right now "since we know the budget reconciliation bill is out there, and it does look like [House] Speaker Mike Johnson [R-La.] is proposing dramatic cuts to Medicaid," Bera said. "Doctors in our caucus are really focusing in on amplifying why Medicaid is so important, why it's so important to Republican districts, to red states, to rural hospitals, and to community health centers. So I do think what's imminent in front of us is, how do we make the case to the American public about how vital Medicaid is? [Medicaid cuts] really would impact not just Democratic districts, [they] would impact a lot of Republican districts, maybe even more so."

As for the cuts to the fee schedule, "we were disappointed that the Physician Fee Schedule fix was not in the continuing resolution bill that Republicans voted for," Bera said. "It is very hard for doctors today to practice and cover their overhead, because Medicare hasn't kept up with the rate of inflation. Our big worry is that you'll start to see doctors drop Medicare patients, because they're not able to cover their overhead. So we've got to do something to help update the fee schedule and our idea would be to tag it to the rate of inflation" -- such as by pegging a yearly rate increase to the Medicare Economic Index, a measure of the healthcare inflation rate.

Prior authorization is another issue the caucus wants to address, Bera said. "That's a bill that we've had with [Rep.] Suzan DelBene [D-Wash.], [Rep.] Mike Kelly [R-Pa.], and others, that has been passed out of the House multiple times," he said, noting that the measure also addressed physician administrative burdens. "Those aren't partisan issues -- those are areas where you think a broad doctors caucus could come together, and those are issues that we should be working on. Also, the physician workforce issues, graduate medical education, student debt -- I think those are all issues that should be part of it, that I think we can all work on."

The GOP Doctors Caucus includes other health professionals such as pharmacists -- does the Democratic group expect to do the same? "We had a robust discussion about that," Bera said. "I think that's eventually where we'll end up, where we'll have other healthcare professionals. But we thought at the launch, let's just call it the 'doctors caucus' and then we'll go from there."