The Senate on April 14 passed H.R. 2, the Medicare Access and CHIP Reauthorization Act of 2015, which eliminates the Medicare Sustainable Growth Rate (SGR) physician payment system and transitions it away from fee-for-service payments to a value-based purchasing system. The bill includes provisions that affect a variety of health care policy areas and is the most significant health care legislation since the enactment of the Affordable Care Act.

The legislation, which passed the House with a vote of 392 – 37 on March 26, will prevent a 21 percent cut in Medicare physician payments that would have been implemented today. The bill amends cost-sharing requirement for some Medicare beneficiaries, extends a number of Medicare provisions and reauthorizes the Children's Health Insurance Program (CHIP) for two years. Before voting 92 – 8 to pass the bill as passed by the House, the Senate rejected six amendments. Under the unanimous consent agreement that governed the rules of debate, the amendments, with the exception of the amendment offered by Sen. Mike Lee (R-UT) needed 60 votes to pass.

• Sen. John Cornyn (R-TX) offered an amendment that would have repealed Affordable Care Act's individual mandate. (Failed 54-45)
• Sen. Michael Bennet (D-CO) offered an amendment that would have reauthorized CHIP for four years. (Failed 50-50)
• Sen. Mike Lee (R-UT) offered an amendment to subject the underlying bill to pay-as-you-go budget requirements. (42-58)
• Sen. Patty Murray (D-WA) offered an amendment to provide Title X facility grants and to fund a payment increase for Medicaid primary care providers. The amendment also would have eliminated abortion restrictions in the bill. (Failed 43-57)
• Sen. Tom Cotton (R-AR) offered an amendment that would remove payment bonuses that are part of a new alternative payment models that are a key aspect of H.R. 2. (Failed 11-89)
• Sen. Ben Cardin (D-MD) offered an amendment that would have permanently repealed caps on physical therapy, occupational therapy and speech-language pathology for Medicare beneficiaries. (Failed 58-42)

After passage of the bill in the Senate, President Obama said in a statement he will be "proud to sign it into law."

The legislation impacts a variety of health care interests and Polsinelli's Public Policy and Health Care Groups will provide a detailed analysis soon.