Swan Commentary: Congress is running out of time to support frontline doctors

As COVID-19 cases continue to surge, our doctors are working tirelessly to ensure patients have the best possible chance of surviving this deadly virus. Unfortunately, the federal government is planning to move forward with policy that would have consequences felt across the entire health care system, a system that is already stressed.

Beginning Jan. 1, 2021, the Centers for Medicare and Medicaid Services (CMS) is prepared to cut the pay of doctors across the country -- including substantial cuts to specialties that have been fighting on the frontlines throughout the COVID-19 pandemic.

Once the new 2021 Physician Fee Schedule goes into effect, reimbursement rates for Medicare will be dramatically lowered for services such as emergency medicine, radiology, and anesthesiology, among others. CMS is currently required by law to maintain budget neutrality, so any reimbursement increases to specialties like primary care come at a cost to other vital treatments and services.

Currently, the federal reimbursement rates do not totally cover the cost of treatment, varying by ZIP code and medical specialty. Therefore, the 2021 Fee Schedule could cause irreversible damage to our health care system. Services rendered by nurse anesthetists will be cut by 11%, radiology by 11%, cardiac surgery by 9%, critical care by 8%, emergency medicine by 6%, infectious disease specialists by 4%, and even podiatry by 1%.

Physicians rely on these reimbursement rates to cover the cost of care and simply cannot stay afloat if they are not adequately reimbursed for treatments. Pay cuts of this magnitude would have been bad news even prior to 2020; instituting these cuts now, when our health care system is already strained, would be disastrous.

Due to COVID-19, specialties such as anesthesiology have already experienced a 70% drop in patient volume this year and emergency rooms have seen decreases of 50%, even in COVID hot spots. Medical practices cannot lose a majority of their projected patient visits and still remain in business. It's estimated that 800,000 U.S. health care workers have lost their jobs since February. Doctors are seeing far fewer patients than prior to COVID-19 and many small clinics have been forced to permanently close their doors.

In Missouri, COVID-19 cases have exceeded 270,000 and there have been more than 3,500 deaths. Unfortunately, the outlook is not improving, as we are currently seeing an average of 4,000 new cases per day.

Congress needs to act quickly to ensure this crisis does not worsen. Our frontline health care workers need financial aid, not misguided pay cuts. If doctors are unable to stay afloat throughout the pandemic, patients will have no one to rely on when we have finally turned the corner on COVID-19.

Over the summer, the American Medical Association and more than other 100 organizations representing physicians and hospitals signed a letter to the U.S. Department of Health and Human Services, explaining the unintended consequences that would follow the 2021 Physician Fee Schedule, noting that Congressional action is needed to halt this policy's implementation.

When in need of medical care, whether for a routine visit or emergency procedure, we trust our doctors to make the right decisions and prioritize our health above all else. With physicians across the country voicing their opposition to policy that they know would wreak havoc on American patients, Congress should listen.

Lawmakers can still prevent these pay cuts from going into effect. In fact, bipartisan legislation was recently introduced that would allow Congress to stop this policy in its tracks. But the clock is ticking. Without timely intervention, CMS' proposed policy will be implemented only five weeks from now. I urge Senators Josh Hawley and Roy Blunt to take action to protect Missouri's doctors and patients. By supporting legislation that waives the budget neutrality requirement for CMS' fee schedule, they can ensure that our health care system will still be firmly in place and Missourians will have access to health care, long after the COVID-19 pandemic is behind us.

Kathryn Swan (R-Cape Girardeau) represents the 147th District in the Missouri General Assembly.