May 7, 2025
The Honorable John Kennedy
U.S. Senator for Louisiana
437 Russell Senate Office Building
Washington, DC 20510
Dear Senator Kennedy,
On behalf of AMAC Action, the advocacy affiliate of the Association of Mature American Citizens (AMAC), with over 2 million members nationwide, we write to express our strong support for the Same Care, Lower Cost Act.
This important legislation takes long-overdue steps to address one of the most persistent inefficiencies in Medicare – payment disparities for identical services based solely on the site of care. For far too long, Medicare has reimbursed hospital outpatient departments (HOPDs) at significantly higher rates than physician offices or ambulatory surgical centers (ASCs), even when the same services can be delivered safely and effectively in those less costly settings. This outdated policy structure not only wastes taxpayer dollars but also drives up premiums and out-of-pocket costs for millions of seniors.
Conservative and bipartisan voices alike have long called for site neutral payment reform. As far back as 2015, Congress made progress by limiting payment disparities for new off-campus HOPDs through the Bipartisan Budget Act. However, existing HOPDs were grandfathered into higher reimbursement rates, leaving a costly loophole in place. The Same Care, Lower Cost Act builds upon this foundation by directing the Secretary of Health and Human Services to identify at least 66 ambulatory payment classifications (APCs) that can be safely and appropriately reimbursed at the same rate regardless of site of service, using MedPAC’s own recommendations. Importantly, emergency and trauma-related services would remain exempt from these provisions, ensuring that urgent care needs continue to receive full support.
This reform is not only fiscally responsible but pro-senior. The Congressional Budget Office estimates that expanding site-neutral payments would save Medicare over $156 billion in the next decade. More importantly for seniors, these reforms are expected to deliver $51 billion in premium reductions, $43 billion in cost-sharing relief, and an additional $43 billion in Medigap savings – totaling $137 billion in direct savings to beneficiaries.
We thank you for introducing the Same Care, Lower Cost Act to help deliver real savings for Medicare and for the seniors who rely on it.
Sincerely,
Andrew J. Mangione Jr.
Senior Vice President
AMAC Action