Why It Matters
In a moment when Congress rarely agrees on anything, a Medicare reform bill has brought Republicans and Democrats together. House Resolution 9693, introduced just last month, has drawn support from 14 Republicans and 13 Democrats, a striking show of unity on healthcare policy in the highly fractious 119th Congress.
The bipartisan bill tackles physician payments under Medicare, a system that advocates say has been broken for years. The measure aims to address what has become a structural problem: payment instability that consolidates medical practices and reduces patient access to independent physicians, particularly in rural areas.
The bill's support from both sides reflects a rare consensus that the current system harms doctors and patients alike, even as lawmakers clash on nearly everything else. Both Republicans and Democrats see independent medical practice as worth defending, and they see Medicare reform as the vehicle to do it.
The Big Picture
H.R. 9693 addresses specific problems within Medicare's physician payment system. The bill proposes tying physician reimbursement to a medical inflation measure, a change from the current system that physicians say leaves them with inadequate compensation. It would also raise Medicare's budget neutrality threshold from $20 million to $54.3 million, a significant increase meant to prevent payment reductions.
Additionally, the bill would establish a physician-led quality reporting process called the Patient Outcome Improvement National Tabulation System (POINTS) and create a new hybrid payment model for primary care. It also aims to reform requirements for participation in Alternative Payment Models, which are payment arrangements outside the traditional fee-for-service system.
The ultimate goal is clear: reverse the consolidation of medical practices that has accelerated in recent years. When practices can't sustain themselves financially under Medicare reimbursement rates, physicians often have no choice but to sell to larger hospital systems or insurance companies. That consolidation, supporters argue, drives up costs and makes care less accessible.
The bill's cosponsors include prominent physician-legislators from both parties. Rep. Kim Schrier, a Democrat from Washington, and Rep. Gregory F. Murphy, a Republican from North Carolina, are co-lead introducers alongside Rep. John Joyce, the Pennsylvania Republican who sponsors the bill. Rep. Ami Bera, a Democrat from California, and Rep. Mariannette Miller-Meeks, a Republican from Iowa, are also among the congressional cosponsors.
Joyce and Schrier co-lead the Republican and Democratic Doctors Caucuses, meaning the bill enjoys support from physician-legislators across the aisle. That suggests the push isn't opportunistic politics but reflects genuine concern about Medicare's trajectory.
The timing of these congressional cosponsors' alignment is worth noting. Previous statements from some of these lawmakers show a consistent pattern of concern about physician payments. Rep. Murphy stated in 2025 that private practice medicine has been decimated due to never-ending cuts to the Medicare fee schedule. Rep. Miller-Meeks, speaking in 2026, stated that Medicare's current payment system places unnecessary burdens on physicians and fails to reflect the realities of patient care. She has also stated that doctors spend too much time on paperwork and not enough time with patients.
These aren't new complaints. Rep. Jimmy Panetta, a Democrat, stated in 2024 that averting harmful cuts to physician reimbursement in Medicare is essential to preserving access to care for Medicare beneficiaries. Rep. Neal P. Dunn, a Republican, stated in 2025 that ensuring providers are fairly reimbursed for prescription drugs will improve patient outcomes and protect rural health centers.
What They're Saying
Medical organizations have responded positively to H.R. 9693. The American College of Physicians praised the bill's inflationary update and increased budget neutrality threshold as providing much-needed stability. The Medical Group Management Association called for addressing the lack of inflationary update under the Medicare physician fee schedule and the ongoing threat of cuts triggered by budget neutrality rules, concerns the bill aims to address.
According to Joyce's press release, the Patients First Act aims to address a system that has undermined patient access to affordable, physician-driven care within communities. Joyce has also stated that the future of patient care, the strength of the physician workforce, and the survival of independent practice depend on congressional action on physician payment reform. That emphasis on preserving independent practice is central to the bill's design.
Rep. Joyce states the bill is aimed at reversing decades of consolidation that drives up the cost of care, especially in rural and underserved areas. The focus on reversing consolidation and supporting independent practices resonates with both parties' stated interests in expanding healthcare competition and access, according to Medical Economics.
The Bottom Line
H.R. 9693 was referred to the House Ways and Means Committee and the House Energy and Commerce Committee. The bill's current status is introduced. With 27 total cosponsors already backing the measure, it appears positioned for committee consideration, though the path forward remains uncertain in a Congress where even bipartisan bills often face delays.
The real test will come when the committees begin deliberations. Until then, the bill represents something rare in contemporary Washington: a moment where both parties see a problem the same way and propose addressing it together.
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