Medi-Cal Expected to Get at Least $10 Billion From Stimulus
The economic stimulus bill is expected to funnel $26 billion to California, including at least $9.2 billion directly to the state primarily for health care and education, the Los Angeles Times reports (Simon/Halper, Los Angeles Times, 2/13).
Among other provisions, the stimulus package includes:
- $24.7 billion for federal subsidies to cover 65% of the cost of health insurance premiums under COBRA for as long as nine months; the provision would apply to workers who were "involuntarily terminated" between Sept. 1, 2008, and Dec. 31, 2009, and whose annual incomes do not exceed $125,000 for individuals or $250,000 for families.
- $19 billion for health care information technology, with $17 billion for investments and incentives through Medicare and Medicaid and $2 billion for a discretionary fund for grants and loans (Reichard, CQ HealthBeat, 2/12); the provision also requires the federal government "to take a leadership role" to develop interoperability standards for health care IT by 2010 (Carey, CQ HealthBeat, 2/12).
- $10 billion in additional funds for NIH, with $8.5 billion allocated for research grants and $1.5 billion allocated to renovate research facilities (Reichard, CQ HealthBeat, 2/12).
- $2.3 billion for Department of Defense construction projects that seek to improve quality of life for service members and their families; the provision includes funds for construction of health and dental clinics on military bases and $481 million for new or expanded medical and social service facilities for wounded service members (Pincus, Washington Post, 2/13).
- $1.2 billion for the Department of Veterans Affairs to construct and renovate health care facilities and national cemeteries (Johnson, CQ Today, 2/12).
- $1.1 billion for research to compare the effectiveness of medications and medical devices; the provision would distribute the funds among the Agency for Healthcare Research and Quality, NIH and the HHS secretary.
- $1 billion for prevention and wellness programs (Carey, CQ HealthBeat, 2/12).
Medicaid Funds for States
The package includes $87 billion in additional federal Medicaid funds for states (Benac, AP/Minneapolis Star Tribune, 2/12).Â Under the provision, states will receive the funds over 27 months, during which time they cannot change their eligibility requirements for the program (Carey, CQ HealthBeat, 2/12).
Language the House Energy and Commerce Committee inserted in the compromise legislation allocated more federal funds for Medicaid to states that have experienced big jumps in unemployment.
According to the Los Angeles Times, California will receive about $11 billion in additional funds for Medi-Cal, the state's Medicaid program.Â That's about $650 million more than the Senate's stimulus bill would have sent to California (Simon/Halper, Los Angeles Times, 2/13).
The San Jose Mercury News reports that although exact figures are not yet available, congressional staffers expect California to receiver about $10 billion in increased federal funds for Medi-Cal (Davies, San Jose Mercury News, 2/12).
Other Medicare, Medicaid Provisions
The stimulus package would:
- Eliminate proposed reductions in Medicare reimbursements to teaching hospitals, a provision that would cost $191 million;
- Eliminate proposed reductions in payments to hospice providers, a provision that would cost $134 million;
- Adjustments Medicare reimbursements for long-term care hospitals, at a cost of $13 million;
- Increase Medicaid payments temporarily to hospitals that treat large numbers of uninsured or underinsured patients, a provision that would cost $460 million;
- Accelerate Medicaid reimbursements to nursing homes and hospitals, a provision that would cost $680 million.
Extend a program that provides Medicaid coverage to individuals who make the transition from welfare to work at a cost of $1.3 billion;
- Extend the program that helps low-income Medicare beneficiaries cover the cost of Part B premiums, a change that would cost $550 million;
- Eliminate out-of-pocket costs for American Indians and Alaska Natives enrolled in Medicaid at a cost of $134 million; and
- Extend or add moratoria on certain Medicaid regulations at a cost of $105 million (Reichard, CQ HealthBeat, 2/12).
The House has scheduled a vote on the compromise economic stimulus on Friday, and the Senate plans to hold a vote later in the day or over the weekend, the AP/Boston Globe reports (Espo/Hirschfeld Davis, AP/Boston Globe, 2/12).
House Minority Whip Eric Cantor (R-Va.) said that "we are suspecting a fairly unified Republican vote" against the stimulus package.
However, according to Roll Call, as many as 30 House Republican might vote in favor of the stimulus package (Kucinich, Roll Call, 2/12).
According to Senate Majority Whip Richard Durbin (D-Ill.), the Senate likely will vote on the stimulus package on Friday evening, and an aide to Senate leaders said that the vote could occur around 7 p.m. (Schatz/Krawzak, CQ Today, 2/12).
Implications of California Budget
The San Francisco Chronicle reports that the budget package under consideration in the California legislature could "blunt the effect" of the stimulus package in California, largely because of state tax hikes and service reductions (Lochhead, San Francisco Chronicle, 2/13).
Next Steps for Obama
After the expected enactment of an economic stimulus package, Obama will have to "choose his next big push," which could involve efforts to reform the health care system or address the long-term financial stability of Medicare, Medicaid and Social Security, the AP/Philadelphia Inquirer reports.
Health care reform seems a "logical choice" for Obama, but he currently does not have an HHS secretary or a "point man" to lead the effort, according to the AP/Inquirer.
In addition, although Obama has promised to hold a summit on entitlement reform, leaders of groups "heavily involved" with Medicare and Social Security said that they have not heard details about such a meeting and "don't know what to expect," the AP/Inquirer reports (Babington, AP/Philadelphia Inquirer, 2/13).
- MSNBC's "Countdown with Keith Olberman" on Thursday commented on allegations from critics that funds for comparative-effectiveness research included in the compromise economic stimulus package would lead to rationed health care. The segment includes comments from Huffingtonpost.com contributor Lawrence O'Donnell (Olberman, "Countdown with Keith Olberman," MSNBC, 2/12).
- NPR's "All Things Considered" on Thursday reported on funds for NIH included in the stimulus package and their potential effects on biomedical research. The segment includes comments from Raynard Kington, acting director of NIH (Harris, "All Things Considered," NPR, 2/12).
- NPR's "Day to Day" on Thursday reported on recent reductions in Medicaid eligibility or enrollment in 12 states and the possible effects of additional funds for state programs included in the stimulus package. The segment includes comments from Diane Rowland, executive vice president of the Kaiser Family Foundation and executive director of the Commission on Medicaid and the Uninsured at the foundation, and Norman Williams, deputy director of California Department of Health Care Services (Weiss, "Day to Day," NPR, 2/12).