File this under unintended consequences. If House Republicans get their way and prevent President Obama from using any discretionary appropriations to implement “Obamacare,” it would cripple existing Medicare programs, many of which are operated under methodologies enacted in the health care law.
In response to a letter from Senate Finance Committee chairman Max Baucus, HHS Secretary Kathleen Sebelius lists the ways the House spending bill would hamper existing entitlements.
“If H.R. 1 were enacted, the Centers for Medicare & Medicaid Services (CMS) would not be able to use CR funds to administer payments based on any rate calculated on the basis of the provisions of the Affordable Care Act — which is to say virtually all rates,” she writes.
Among many other things, the law rescinded the old methodology by which the government paid Medicare Advantage providers and replaced it with a new one. The House spending bill would prohibit HHS from making payments under the new regime. And with the old regime eliminated, the department would have no legal authority to cover those services, according to Sebelius.
“This would seem to mean that payments to [Medicare Advantage] organizations would have to be suspended, risking a significant disruption in services to beneficiaries enrolled in Medicare Advantage,” Sebelius writes.