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Summaries of health policy coverage from major news organizations

New Senate Changes to ‘Extenders’ Bill Unlikely To Attract Extra Support

On Wednesday, Senate Democratic leaders formally unveiled a new substitute amendment to the "extenders" bill (HR 4213), in an attempt to secure the votes of several moderate Democrats and Republicans and advance the measure to the floor, CQ Today reports (Rubin/Schatz, CQ Today, 6/23).

However, it appears that the new changes to the extenders bill have failed to attract the additional support needed to end debate on the bill (Montgomery, Washington Post, 6/24).

Moderate lawmakers' main concerns continue to revolve around the total cost and deficit projections of the legislation, which includes a revised state Medicaid assistance package, as well a series of tax breaks and unemployment benefits extensions (CQ Today, 6/23).

Changes, Cost Projections

Under the latest changes to the bill, a provision that would have provided states with nearly $24 billion in additional federal Medicaid funds for six months has been scaled back. States still would receive the aid through June 2011, but the federal Medicaid assistance percentage would be gradually reduced from 3.2% in the first three months of 2011 to 1.2% from April to June, Reuters reports.

The "phase down" approach would cut roughly $8 billion over 10 years from bill's total cost, Democrats reported in a summary of the changes (Smith/Lambert [1], Reuters, 6/23).

Senate Democrats also have added new revenue-raising provisions to the bill and omitted about $2 billion in previously appropriated spending related to stimulus and defense accounts and food stamp benefits.

Preliminary estimates have found that the revised legislation would add roughly $36 billion to the federal deficit over 10 years, compared with about $80 billion in a previous version of the extenders bill from three weeks ago (Taylor, AP/San Francisco Chronicle, 6/23).

The bill is now projected to cost about $110 billion, of which about $75 billion has been offset with the spending cuts and targeted tax increases, Dow Jones/Wall Street Journal reports (Vaughan, Dow Jones/Wall Street Journal, 6/23).

Bill Changes Fail To Secure Needed Votes

Despite days of negotiations, a senior Democratic aide on Wednesday said that Senate Majority Leader Harry Reid (D-Nev.) has not been able to persuade any Republicans to vote for the extenders bill, the Post reports.

Although Democrats hold 59 seats in the chamber, they expect to lose the vote of at least one member -- moderate Sen. Ben Nelson (D-Neb.), who has expressed concern with the cost of some provisions in the bill that have not yet been offset.

Reid needs 60 votes to end debate on the legislation and bring the measure to the floor, meaning he needs at least two Republican votes (Washington Post, 6/24).

On Wednesday, Reid filed for cloture to end debate on the bill, but the Senate Democratic aide acknowledged that the vote likely would once again fail to overcome another Republican filibuster (AP/San Francisco Chronicle, 6/23).

The procedural vote could take place as soon as late Thursday or early Friday (Smith/Lambert [1], Reuters, 6/23). However, if the vote fails, Democrats might abandon the measure, the AP/Chronicle reports (AP/San Francisco Chronicle, 6/23).

House Democrats, Governors Urge Senate To Act Quickly

House Democrats appear to be losing patience with the continued delays in the upper chamber, CongressDaily reports.

House Democrats recently opted to monitor the developments in the Senate on the extenders bill before they take any further action related to the Senate-approved stand-alone "doc fix" bill (HR 3962), which would delay a 21% cut to physicians' Medicare reimbursements for six months (Cohn, CongressDaily, 6/23).

Meanwhile, governors also are pressuring the Senate to move quickly on the extenders bill. On Tuesday, the National Governors Association sent a letter to Senate leaders urging them to act quickly on the broader extenders bill, particularly because it includes crucial Medicaid funding that state officials were banking on in their annual budgets, Reuters reports (Smith/Lambert [2], Reuters, 6/23).

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