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Conrad: Mend health care law, 'don't end it'

FARGO -- Sen. Kent Conrad, flanked by hospital administrators and a representative of the state's doctors, on Friday scolded anyone suggesting it would be easy to restore increased Medicare payments to North Dakota medical providers if the health reform law is repealed.

The health reform law, upheld by the U.S. Supreme Court, includes the Frontier Amendment, which addressed historical inequities in payments to North Dakota hospitals and doctors, boosts Medicare payments "significantly more than $650 million" over 10 years, Conrad said.

The measure, which also applies to several other heavily rural states, was a "struggle" that took almost a decade to achieve, and was sought by North Dakota hospitals and doctors, the veteran Democratic senator said.

In effect, North Dakota hospitals and clinics were penalized by Medicare payment formulas because they have historically provided very cost-effective care, a problem that grew worse with time.

"Our levels of reimbursement just kept plunging," Conrad said. "When people say repeal the health care law, people in North Dakota need to know that there are consequences."

When asked by a reporter who his comments were directed at, Conrad said, "I'm not referring to any specific person," though the senator, who is not running for re-election, acknowledged that one reason the issue was of concern is because it is a campaign year.

Rep. Rick Berg, R-N.D., who is the GOP candidate for the Senate seat Conrad is vacating, has long called for repeal of the health reform law, and television spots on behalf of his campaign have advocated scrapping the law.

A spokesman for Berg provided a statement to The Forum:

"Rick believes that President Obama, Harry Reid and Nancy Pelosi wasted an opportunity for real reform when they forced through the $1.7 trillion government takeover of our health care system," Chris Pack, Berg's communications director, said in the statement, referring to Democratic congressional leaders.

Polls show 70 percent of North Dakotans did not favor the health reform law, which Pack said would "bankrupt" Medicare in 12 years.

"There are issues with our health care system that need to be addressed, including the Frontier Amendment, which Rick has consistently fought for and is a matter of fairness for rural hospitals."

In his remarks, Conrad said the health reform law is not a government takeover of health care, since it preserves private health insurance, and said the nonpartisan Congressional Budget Office projected it will save $1.3 trillion over 20 years.

Administrators for Sanford Health, which hosted the Frontier Amendment discussion, and Essentia Health joined Conrad in saying that keeping the provision is important to maintaining the state's health care delivery.

"It levels the playing field for facilities and Medicare recipients," said Courtney Koebele, executive director of the North Dakota Medical Association, which represents about 1,000 physicians.

The enhanced payments under the Frontier Amendment are not a bonus, and the state's providers are not getting anything extra, but reflects that they do not get discounts when having to buy technology or recruit physicians and other medical professionals, health care executives said.

Instead of repealing the health care law, Washington should work to improve health reform, Conrad said. "My message is mend it, don't end it," he said.