Former Rep. Michael Burgess, MD, urges Congress to pass the Patients First Act to stabilize Medicare physician payments, preserve independent practices and protect patients’ access to care, particularly in rural and underserved communities.

America’s doctors rely on the healthcare system to give them the resources and stability they need to run a successful practice. But increasingly, they are finding that they can’t count on Medicare to cover the full cost of treating seniors and people living with disabilities. When Medicare payments fail to keep up, patients feel it first.

A new rule beginning Oct. 22 will threaten the healthcare of millions of Americans. The rule, “Indefinite Suspension of the De Minimis Exemption for Mail Shipments,” will effectively end Americans’ ability to personally import their prescription medicines.

Adjusted for practice-cost inflation, Medicare physician payment has dropped 33 percent over the past 25 years, according to the American Medical Association. That is not a one-year dip. It is a quarter-century of erosion, driven in part by budget-neutrality rules that have not been updated in more than thirty years and by a steady drumbeat of annual cuts that Congress has had to scramble to soften, year after year, without ever fixing the underlying machinery.

Congress is considering the first major overhaul of how Medicare pays doctors in more than a decade, and both Democrats and Republicans appear to agree on the outlines of an approach. The main policy under consideration would link Medicare’s doctor pay rates to a medical inflation measure, giving doctors guaranteed pay boosts, as hospitals and other parts of the health care system have long received.

At its heart, the Patients First Act (H.R. 9693) would help physicians nationwide who are struggling to expand patients’ access to high-quality care. Ultimately, the bipartisan bill would stabilize physician reimbursement and help practices weather the rising cost of care—costs that are contributing to physician shortages, fewer patient options, and higher out-of-pocket expenses for Washingtonians who have to travel farther for care.

Nearly one in five Minnesotans — about 1.1 million people — rely on Medicare, the federally funded health insurance program primarily serving those 65 and up. Yet Medicare payments to physicians have been cut, frozen or patched for years while the cost of running a practice has risen. Adjusted for inflation, physician pay under Medicare has fallen roughly 33% since 2001.

Orthopaedic surgeons understand how important Medicare is to the people we serve, and most physicians remain committed to caring for Medicare patients. But it is unrealistic to assume practices can absorb reductions year after year without consequences. If this trajectory continues – and these latest proposed cuts suggest they might – there will soon come a day when more practices limit the number of Medicare patients they accept, stop offering certain services or leave the Medicare program altogether.

When adjusted for practice-cost inflation, Medicare physician payments have dropped 33% over the past 25 years, according to the American Medical Association.Compounding Medicare cuts have forced many physicians to opt out of independent practice, sell to larger institutions or retire early. Many physicians have stopped accepting new patients with certain Medicare plans, exacerbating the healthcare access crisis.