Doctors who treat Medicare beneficiaries are in for leaner times, judging from the program’s recently announced reimbursement update. And it will be those beneficiaries who will pay the price.

The proposed changes to Medicare’s “fee schedule” would technically increase doctor reimbursement by 2.5%. But the government is also proposing to cut payments for many procedures with a 2.5% “efficiency adjustment.” This, together with several other changes to how doctor pay is calculated, will result in cuts in reimbursement for many physicians.

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The American Medical Association estimates that, under the new fee schedule, more than one-third of oncologists will see their Medicare payments slashed by 10% to 20%. The same share of obstetricians and gynecologists would also face cuts.

The proposal promises to worsen an already dire situation for physicians — Medicare has been squeezing their pay for years. After adjusting for inflation, Medicare physician reimbursement has fallen 33% since 2001.

This decline in pay doesn’t just hurt doctors; it undermines access to care for patients, particularly the more than 33 million who rely on Medicare.

Already, the United States does not have enough doctors to meet demand. The Association of American Medical Colleges projects that our nation will be short as many as 86,000 doctors by 2036.

Even that projection might be optimistic. A separate report from the National Center for Health Workforce Analysis forecasts a shortage of more than 187,000 doctors by 2037.

Nor is it just doctors who will be in short supply should current trends continue. A new Harris poll of front-line healthcare workers finds that well over half plan to look for, interview for, or leave for a different job by the end of the year.

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This pending exodus of healthcare professionals would be difficult to forestall under ideal circumstances. Cutting doctor payments from Medicare, making it harder for physicians to acquire, retain, and properly compensate staff, will only exacerbate the problem.

Doctors have suffered under Medicare’s inadequate reimbursement arrangement for too long. It’s up to Congress to align Medicare’s flawed payment structure with economic reality.

Sally C. Pipes is President, CEO, and Thomas W. Smith Fellow in Health Care Policy at the Pacific Research Institute. Her latest book is The World’s Medicine Chest: How America Achieved Pharmaceutical Supremacy—and How to Keep It. Follow her on X @sallypipes.