House Republicans announced a plan to bring SGR repeal to the floor, but with the bill paid for by repealing the individual mandate in the Affordable Care Act.  This would almost certainly kill any chance of repeal before the expiration of the current patch, and possibly into 2015.   Because the individual mandate is so essential to the Affordable Care Act, this bill would be dead on arrival in the Senate, virtually guaranteeing a nine-month patch in the short term, and pushing debate over repeal into a lame duck Congress at the end of 2014.  Most of organized medicine, which had endorsed the current SGR bill, is suspending advocacy efforts pending an adjustment in strategy and message.

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