I voted in favor of the conference agreement on the Middle Class Tax Relief and Job Creation Act of 2012 because I believe it is necessary for our nation's continued economic recovery, which still remains fragile. Economists of every stripe have endorsed the three major components of the bill which will provide some additional confidence for both consumers and business. However, I have serious concerns about parts of the compromise, chiefly the lack of a permanent repeal of the sustainable growth rate (SGR) formula and the funding sources for the ten-month SGR ``patch.'' Medicare cuts to community hospitals and skilled nursing facilities included in the compromise threaten the already thin financial margins these institutions are operating on. Also included in the compromise is the elimination of $5 billion from the Prevention and Public Health Fund created by the Affordable Care Act. These cuts will stifle progress on disease prevention which in the long-term is the best way to reduce health care spending. And, the fact that these programs will be cut to pay for a short term fix of a broken SGR formula that was passed into law nearly two decades ago and has proven to be totally infeasible, is particularly galling. While the window of opportunity to repeal the SGR permanently in this package has passed for now, Congress still has an obligation to enact a permanent fix to this flawed policy when the ten-month fix expires.…
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