Congress Reaches Deal on Economic Stimulus With Health Care Funds
On Wednesday, House and Senate negotiators reached a tentative compromise on a $789.5 billion economic stimulus package that includes some concessions on health care, "clearing the way" for final passage of the package by the end of the week, the New York Times reports (Herszenhorn/Hulse, New York Times, 2/12).
According to the Washington Post, "despite the acknowledgement of ceding some ground," President Obama "secured many of his biggest priorities in the legislation, including the longer-term health care and energy investments that the administration views as a down payment on broader reforms" (Murray/Kane, Washington Post, 2/12).
Among other provisions, the compromise stimulus package would:
- Provide federal subsidies for health insurance under COBRA that would cover 60% of the cost of premiums for as long as nine months and impose income eligibility limits for the subsidies (Rogers, The Politico, 2/12);
- Provide $19 billion for health care information technology, with bonuses of between $44,000 and $64,000 for physicians and as much as $11 million for hospitals for the implementation of electronic health records; physicians and hospitals must implement EHRs by 2014 or face the loss of Medicare reimbursements (Hitt/Weisman, Wall Street Journal, 2/12);
- Distribute 65% of $87 billion in additional federal funds for state Medicaid programs under the current formula and distribute the remainder based on growth in unemployment rates in states (Rubin/Ota, CQ Today, 2/11);
- Provide $10 billion to NIH for biomedical research (Espo, AP/Boston Globe, 2/11); and
- Provide $1.1 billion for research to compare the effectiveness of medications and medical devices (Hitt/Weisman, Wall Street Journal, 2/12).
The compromise stimulus package does not include a provision in the House version that would have allowed states to expand Medicaid coverage to recently unemployed workers (Meckler, Wall Street Journal, 2/12).
Prospects for Passage
Some Democratic senators "initially balked at accepting such steep cuts" to provisions related to health care and other areas, but Senate Majority Leader Harry Reid (D-Nev.) "got his reluctant caucus to sign off on a measure many thought should be larger than the $838 billion measure the Senate approved," Roll Call reports (Pierce, Roll Call, 2/12).
According to the Washington Times, the three Republican senators who voted for the Senate version of the stimulus package -- Sens. Arlen Specter (Pa.), Olympia Snowe (Maine) and Susan Collins (Maine) -- said that they support the compromise package, "virtually ensuring it will pass" in the Senate (Miller/Sands, Washington Times, 2/12).
In the House, "as many as 20 or more Republicans could break ranks to support" the compromise stimulus package, as the cost has decreased from the $819 billion version passed last month by the chamber without any Republican support, The Politico reports (The Politico, 2/12).
However, according to the Post, the "changes did not make much of a dent in Republican resistance to the measure" (Washington Post, 2/12).
Congressional Democrats said that the House could vote on the compromise stimulus package as early as Thursday, with a vote possible in the Senate on Friday (Roll Call, 2/12).
Concerns About Comparative-Effectiveness Research Provision
A provision included in the compromise economic stimulus package that would provide about $1 billion for comparative-effectiveness research has raised concerns about use of the information to ration health care services, the San Francisco Chronicle reports.
Under the provision, the federal government would establish an agency that would help coordinate comparative-effectiveness research.
Supporters maintain that comparative-effectiveness research would "improve quality of care and reduce health costs by limiting the use of drugs and treatments that do not work well," but opponents argue that the "government could use the information to deny certain treatments or ration health care options for patients," according to the Chronicle (Colliver, San Francisco Chronicle, 2/11).
In addition, some health care industry groups have raised concerns about whether language from the House version of the stimulus package that could link comparative-effectiveness research with coverage decisions will appear in the compromise package.
The Senate version of the stimulus package "specifically prohibits the government from making any coverage decisions based on this research, or even from issuing guidelines that would suggest how to interpret the research results," according to Senate Finance Committee documents (Carey, CQ HealthBeat, 2/11).
On Wednesday, KQED's "The California Report" featured a discussion with Dena Bunis -- Washington bureau chief of the Orange County Register -- about the implications of the stimulus package for California (Myrow, "The California Report," KQED, 2/11).This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.