Senate bounces spending bill back to House with 2.5% Medicare rad pay fix
The U.S. Senate on Tuesday bounced a massive spending bill back to the House for further consideration. After senators had initially excluded any pay changes for radiologists and other docs, amendments incorporated a 2.5% increase for 2026, drawing mild praise from physicians.
In addition, there are no restrictions on pass-through entity taxes (PTET), which “benefits independent physician practices,” surgeon Adam Bruggeman, MD, said Tuesday. However, others expressed concern about massive cuts to Medicaid totaling nearly $1 trillion. The Senate made the decision via a 50-50 tie, with Vice President JD Vance breaking the tie.
“Taken in aggregate, the Medicaid provisions will negatively impact payment rates in the states, create confusion for patients who don't realize they've lost coverage until they show up in their doctors office, and significantly increase uncompensated care,” said Anders Gilberg, senior VP of government affairs for the Medical Group Management Association, which represents practices across radiology and other specialties.
Gilberg also credited Rep. Greg Murphy, MD, R-N.C., for “keeping Medicare doc payment front and center” as the bill headed to the House for potential further modifications. Among other positives, Bruggeman noted that the Senate also increased the cap for unsubsidized student loans to $200,000 (previously $138,500) but removed PLUS loans. The latter are offered by the Department of Education and once covered all costs for graduate school.
“So, this will certainly have an impact on graduate students,” said Bruggeman, who is chairman of the American Academy of Orthopaedic Surgeons Council on Advocacy. “The hope from Congress is that this will encourage graduate programs to lower tuition,” he added.
Both the American Medical Association and American Hospital Association criticized cuts to the Medicaid program Tuesday. AHA noted that the legislation will cause roughly 11.8 million Americans to be displaced from their healthcare coverage and left uninsured. The association believes hospitals will be forced to make service and staff reductions, leading to longer wait times for specialty care.
“We are deeply disappointed by today’s vote in the United States Senate to advance the One Big Beautiful Bill Act (H.R. 1),” AHA President and CEO Rick Pollack said in a statement July 1. "The real-life consequences of these nearly $1 trillion in Medicaid cuts—the largest ever proposed by Congress—will result in irreparable harm to our healthcare system, reducing access to care for all Americans and severely undermining the ability of hospitals and health systems to care for our most vulnerable patients.”
The Senate bill also fails to eclipse doc-pay reforms outlined by the House, which added a modest inflationary update tied to the Medicare Economic Index, the AMA added.
“The cuts to federal healthcare programs, including Medicaid and CHIP, will shift costs to the states and specifically to physicians and hospitals to provide uncompensated care at a time when rural hospitals and physician practices are struggling to keep their doors open,” AMA President Bobby Mukkamala, MD. said. “While we appreciate that the bill provides a temporary lift for Medicare payments in 2026, it falls short of the House-passed language tying Medicare updates to the Medicare Economic Index and far short of what is needed to preserve access to care for America’s seniors.”
Sen. Roger Marshall, MD, R-Kan., meanwhile, insisted Monday that the Senate bill “preserves, protects and strengthens” Medicaid for “those who need it most.”
“We’re going to make sure that your seniors in nursing homes, pregnant women, children, and people with disabilities have Medicaid in the future; we are fiscally making Medicaid more sound,” Marshall, a practicing OB-GYN specialist before joining Congress, said in a prepared remarks June 30.
AHA reported Tuesday afternoon that the House Rules Committee was meeting to begin preparing the bill for floor consideration. The Radiology Business Management Association also said it was closely monitoring the situation Tuesday after the Senate’s passage. It’s urging House leaders to push for the reintroduction of an inflation-based update for rad pay in 2026, along with reform in the flawed budget neutrality process.
“Physicians, including those in radiology, continue to face the dual challenge of declining Medicare reimbursement and escalating operational costs,” RBMA Co-executive Director Linda Wilgus told Radiology Business. “These pressures threaten the sustainability of practices and the accessibility of essential diagnostic services. As the House considers this legislation, RBMA calls on lawmakers to prioritize policies that support long-term stability in the healthcare sector.”
Inside Health Policy reported that, as of 7 p.m. Tuesday evening, a handful of House Republicans had signaled disappointment about the Senate’s changes.
Radiology Business will update this story as more information becomes available.
Marty Stempniak has covered healthcare since 2012, with his byline appearing in the American Hospital Association's member magazine, Modern Healthcare and McKnight's. Prior to that, he wrote about village government and local business for his hometown newspaper in Oak Park, Illinois. He won a Peter Lisagor and Gold EXCEL awards in 2017 for his coverage of the opioid epidemic.