Lawmakers Agree to Tentative Deal Averting Government Shutdown
On Thursday night, House and Senate lawmakers reached a tentative agreement on a $1 trillion omnibus spending proposal for fiscal year 2012 that includes $69.7 billion in funding for HHS, Modern Healthcare reports. Approval of the plan by the end of Friday would avert a government shutdown (Zigmond, Modern Healthcare, 12/15).
The agreement is based on a House-Senate conference report that the GOP developed into a bill (HR 3671) earlier this week. However, House Minority Leader Nancy Pelosi (D-Calif.) warned the GOP that Democrats would not support the stand-alone bill at that stage. Thus, lawmakers continued work on the conference report and expect both chambers to vote on it by Friday (Berman, The Hill, 12/15).
The $69.7 billion in HHS funding is about $700 million less than the FY 2011 budget and $3.4 billion less than what President Obama requested. The proposal also includes $3.9 billion for CMS Program Management, which is $241 million more than last year but $517 million below what the president requested. In addition, NIH would receive $30.7 billion in FY 2012, an increase of $299 million from last year and $758 million below Obama's request (Modern Healthcare, 12/15).
Debate on Payroll Tax Break Extension Continues
Meanwhile, lawmakers continue debate on a payroll tax break extension that also would delay scheduled reimbursement cuts to Medicare physicians, The Hill reports (Bolton, The Hill, 12/15).
The House on Tuesday voted 234-193 to pass a GOP-helmed payroll tax cut extension (HR 3630). The bill would extend a $1,000 payroll tax break that is set to expire at the end of 2011. Meanwhile, the "doc fix" would stave off a nearly 30% cut to Medicare physician payment rates that is scheduled to take effect on Jan. 1, 2012. Instead, the legislation would increase reimbursement rates by 1% over the next two years.
The plan would pay for the $38 billion fix in part by increasing Medicare premiums for high-income beneficiaries and by redirecting funding from the federal health reform law that was intended for prevention and public health services.
The bill's chances for passage in the Senate are slim, as Senate Democrats worry that the cost of the tax break extension will fall on middle-income residents. Democrats originally wanted to pay for the measure with a surtax on high-income individuals but have offered to drop the idea if Republicans make certain concessions in exchange (California Healthline, 12/15).
According to The Hill, lawmakers are about $90 billion apart on a deal for the extension.
McConnell, Reid Developing Backup Plan
Senate Majority Leader Harry Reid (D-Nev.) and Senate Minority Leader Mitch McConnell (R-Ky.) also are working on a two-month extension of the tax break in case lawmakers cannot reach a broader agreement, The Hill reports (Bolton, The Hill, 12/15). The temporary plan also would delay the Medicare reimbursement cuts during that period (AP/Washington Post, 12/16).
Reid said, "I always have a Plan B," adding, "I hope we don't get there, but if we do, what the two-month would accomplish is make sure that people would continue to get the payroll tax holiday and also the unemployment benefits, and also doctors would [be] able to continue their work" with Medicare beneficiaries (Shiner, Roll Call, 12/15).