Economic Stimulus Plan Clears U.S. House Without GOP Support
The House on Wednesday voted 244-188, with no Republican support, to pass a two-year, $819 billion economic stimulus package that includes funds for health care, the Washington Post reports (Kane, Washington Post, 1/29).
The stimulus package includes about $153.2 billion in new funds for health care (USA Today graphic, 1/29).
Health Care Overview
The stimulus package includes about $20 billion for investment in health care information technology and about $87 billion in additional federal funds for state Medicaid programs (Lightman, McClatchy/Philadelphia Inquirer, 1/29).
According to House Democratic staff, California would garner $11 billion to help with costs for Medi-Cal, the state's Medicaid program (Coile, San Francisco Chronicle, 1/29).
In addition, the stimulus package includes about $40 billion to subsidize health insurance premiums for recently unemployed workers under COBRA and expand the program (Lightman, McClatchy/Philadelphia Inquirer, 1/29).
The stimulus package also includes funds for a provision that would allow low-income workers who lose jobs that did not provide health insurance to apply for Medicaid through 2010 (Weisman et al., Wall Street Journal, 1/29).
Among the provisions related to health care, the stimulus package includes:
- $4 billion for preventive care, $1.5 billion for community health centers;
- $420 million to fight avian flu; and
- $335 million for programs that fight sexually transmitted infections and tuberculosis (Washington Times graphic, 1/29).
According to the Chronicle, the vote on the economic stimulus package marked a "victory, of sorts, for Republicans," who "have been winning the public relations battle over the bill in recent days by portraying certain provisions in the bill as 'pork'" (San Francisco Chronicle, 1/29).
House Minority Leader John Boehner (R-Ohio) said that the stimulus package includes a number of "wasteful" provisions, such as a measure that would provide $300 million for CDC "to do whatever" (Bendery, Roll Call, 1/28).
In addition, Republicans criticized some "little noticed provisions that would greatly expand access to health care for the unemployed" as a "Trojan horse for Democrats' hopes of expanding the federal role in health care," the Los Angeles Times reports.
Rep. Michael Burgess (R-Texas) said, "Things that should be debated in the context of health care reform are being rushed through in this stimulus bill" (Hook, Los Angeles Times, 1/29).
As the Senate prepares to consider a different version of the economic stimulus package next week, senators are "gearing up for a debate for the ages," and President Obama is "putting on a full-court press for a bigger, bipartisan vote" to "muscle the bill over the line," the Christian Science Monitor reports (Russell Chaddock, Christian Science Monitor, 1/29).
In addition, in the event that the Senate passes the stimulus package, differences with the House version could delay final approval of the package.
"In particular, House and Senate Democrats are split over how to divide $87 billion in relief to the states for Medicaid, with senators favoring a formula more beneficial to less-populous states," according to the New York Times (Calmes, New York Times, 1/29).
The House version of the stimulus package would distribute 52.5% of the funds to states under the current Medicaid formula and distribute the remainder as part of a "bonus" program to help states with high growth in unemployment rates.
The Senate version would distribute 80% of the funds to states under the current Medicaid formula.
According to the Wall Street Journal, the debate "pits Democrats from rural and urban areas against one another," as many rural states have high unemployment rates but not high growth in unemployment rates (Wall Street Journal, 1/29).
Lawmakers, Budget Experts Raise Concerns
Some lawmakers and budget experts have raised concerns that many of the temporary increases in spending included in the economic stimulus package for health care and other programs could become permanent, USA Today reports.
Maya MacGuineas, president of the Committee for a Responsible Federal Budget, raised specific concerns about increases in spending for health care IT, COBRA and an expansion of the earned income tax credit for low-income workers.
Robert Bixby, executive director of the Concord Coalition, said, "The things that are being described as investments ... are by definition going to last longer," adding, "The crisis environment shouldn't be used to add permanent new entitlements" (Wolf, USA Today, 1/29).
Meanwhile, "it may be difficult to predict how well the overall plan will work," as use of a large portion of the funds for health care and other programs included in the stimulus package likely would not occur until 2012, according to the New York Times.
In addition, although the $87 billion in additional federal funds for state Medicaid programs included in the stimulus package likely will "go a long way to help states close their budget gaps" and "prevent cuts that would make the downturn even worse, ... there has been little discussion so far on a proposal ... that aid to states be provided in the form of loans, encouraging them to spend the money wisely and, once the economy rebounds, obligating them to help reduce the national debt," the New York Times reports (Herszenhorn, New York Times, 1/29).
Health Care IT Investment
The $20 billion for investment in health care IT included in the economic stimulus package "would be, by far, the biggest government infusion to enable medical information to follow patients back and forth among doctors' offices, hospitals and other providers," the Philadelphia Inquirer reports.
Most health care IT experts support the investment, but many have raised concerns about the privacy protections included in the House version of the stimulus package and the lack of interoperability standards (Goldstein, Philadelphia Inquirer, 1/29).
NPR's "All Things Considered" on Wednesday examined provisions in the economic stimulus package that would subsidize health insurance premiums for recently unemployed workers under COBRA and expand the program (Rovner, "All Things Considered," NPR, 1/28).On Thursday, NPR's "Morning Edition" reported on the House passage of the stimulus package (Cornish, "Morning Edition," NPR, 1/29). 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.