House Expected To Take Action on ‘Extenders’ Package This Week
The House Rules Committee on Monday is expected to take up the so-called "extenders" package (HR 4213), which the Senate and House tax-writing committees released last week, before it proceeds to a likely vote on the House floor on Tuesday, CQ Today reports.
The package includes a plan to prevent a significant cut to physicians' Medicare reimbursement rates through 2013, along with extensions on a series of expired tax cuts, state Medicaid funding, and health benefits and subsidies for unemployed workers.
The Congressional Budget Office released analysis on Friday that found the bill would increase the federal deficit by $133.7 billion over 10 years. According to CBO, about 30% of the package's tax cuts and spending are offset, which has become a topic of concern among lawmakers. CQ Today reports that the rest of the billâs spending has been "chalked up" to emergency spending or exemptions under new pay/go rules enacted this year (Rubin, CQ Today, 5/21).
Hospitals Protest Tighter Payment Proposal
On Friday, at least two hospital groups expressed opposition to a provision in the bill, which they said would reduce their Medicare payments by as much as $4.5 billion over 10 years, The Hill reports (Pecquet, The Hill, 5/21).
The provision would reconfigure the Medicare policy known as the "72-hour rule," which requires hospitals to bill CMS for therapeutic services provided to patients within 72 hours of their admission along with patients' hospital stay costs. The package would expand the number of services ineligible for separate reimbursements (DoBias, Modern Healthcare, 5/20). As a result, the reconfiguration would be "less lucrative" for hospitals, The Hill reports.
Christiane Mitchell, director of federal affairs for the Association of American Medical Colleges said in an e-mail to the group's members last week, "Hospitals have already accepted $155 billion in Medicare and Medicaid cuts through health care reform," adding, "We cannot support an additional $4.5 billion in Medicare hospital payment cuts."
Mitchell also suggested that pending Medicare rules could lead to more cuts that could significantly affect teaching hospitals. She urged members to share their ideas for a strategy to block the proposed cuts and to speak to their congressional representatives about the issue (The Hill, 5/21).
The American Hospital Association also has said that it would work to block the provision (Modern Healthcare, 5/20).
Democrats, however, contend that the proposed reconfiguration addresses a loophole in the health reform law that would have allowed hospitals to bill CMS for services separately, The Hill reports.
Senate Finance Committee Chair Max Baucus (D-Mont.) said the policy "protects" Medicare. A summary of the bill said CBO is still calculating the provision's savings to Medicare (The Hill, 5/21).
Prospects of Bill Still in Doubt
Support for the bill in the Senate remains unclear, CQ Today reports.
House approval of the bill on Tuesday would allow the Senate to schedule a cloture vote as early as Thursday, clearing the way for a final vote for passage. However, any delay could make it easier for Senate Republicans to block the package from a vote before lawmakers adjourn on Friday for the Memorial Day recess.
Baucus and House Ways and Means Committee Chair Sander Levin (D-Mich.) have expressed confidence that they will be able to secure enough votes for passage, but they face "two distinct challenges," according to CQ Today.
Senate moderates are pushing for more of the bill's costs to be offset, while some pro-business Senate Democrats are urging negotiators to scale back a provision for higher taxes on businesses (CQ Today, 5/21).
According to CongressDaily, several influential labor unions and interest groups are "blitzing" lawmakers to support the package (Cohn, CongressDaily, 5/21).