Another reason for concern: CBO releases its revised budget estimates in August. If the price tag for SGR repeal posts a significant increase, "any chance of repeal this year is dead," stated Williams. In that case he expects Congress will do another temporary "doc fix" bill at the last minute before Christmas that corrects the problem for "somewhere between one and (maybe if Boehner gets his way) four years."
Williams and Gilberg agree that while policy and price will be dealt with in separate pieces of legislation, even the $139 billion price tag for SGR repeal will be a tough sell. "I'm hard pressed to see how rank and file Republicans in the House will support anything that increases spending by that amount," said Williams.
Gilberg says it's unlikely that any pay fors or offsets will be addressed in a stand-alone SGR bill. That could be too polarizing, especially if the SGR funding involved reducing the money available for other parts of the healthcare budget.
The more likely scenario says Gilbert is that SGR repeal funding will be part of comprehensive legislation addressing deficit reduction or something equally large in scope. "It's just easier to do that way."
Williams agrees. "[Republicans] might be willing to hold their noses and vote for [the cost of repealing the SGR] as part of a larger package like tax reform."