Progress Stalled on ‘Extenders’ Bill; Costs Remain Top Concern
On Wednesday, the Senate continued work on the so-called "extenders" bill (HR 4213) amid growing concern from some senators about its cost and deficit impact, raising the likelihood that the final vote will be delayed until next week, CQ Today reports.
The Senate's version of the bill includes a 19-month delay on a scheduled 21% cut to physicians' Medicare reimbursements and a substitute amendment that would extend federal Medicaid assistance to states for six more months at the cost of about $24 billion.
According to the CQ Today, some moderate Democrats and Republicans have declined to endorse the bill because it would cost an estimated $140 billion and add nearly $78 billion to the federal deficit over the next decade.
At least three moderate Democrats have refused to declare the state Medicaid aid extension package as emergency spending -- which would exempt it from pay/go rules.
In addition, Sens. Susan Collins (R-Maine) and Olympia Snowe (R-Maine) -- two moderates who have voted with Democrats in the past -- have concerns about the bill's effect on the deficit.
Outlook in the Senate
The Senate is not scheduled to debate the bill on Thursday or hold roll call votes on Friday and Monday, CQ Today reports. Therefore, final action on the bill likely will be delayed until the middle of next week (Rubin, CQ Today, 6/9).
Despite the delay, Democrats said that they are confident that the legislation will be approved because it includes provisions that members from both parties favor, such as large business and personal tax breaks, the New York Times reports (Hulse, New York Times, 6/9).
Senate Democratic leaders need votes from all 59 Democrats and at least one Republican to pass the bill (CQ Today, 6/9).
Latest Action on Extenders Bill
During Wednesday's debate on the extenders bill, Sen. Bob Casey (D-Pa.) introduced an amendment that would extend federal COBRA subsidies for unemployed U.S. residents through the end of November, MLive.com reports.
Under the amendment, workers who are laid off from June 1 through November would qualify for the subsidies (Headapohl, MLive.com, 6/9). An extension of COBRA subsidies was omitted from the House-approved bill. The provision would cost about $7 billion.
The Senate also voted to table two other amendments to the bill that were related to the new health reform law, CQ Today reports. Senators rejected an amendment by Sen. Benjamin Cardin (D-Md.) that would have allowed members under the Federal Employees Health Benefits Plan to immediately enroll children up to age 26, instead of waiting until the start of the year.
The Senate also voted down an amendment by Sen. Pat Roberts (R-Kan.) that would have exempted medical devices from the 2.3% excise tax included in the overhaul (Weyl, CQ Today, 6/9).
Governors, Advocates Pressure Senate To Support Medicaid Package
Four Democratic governors on Wednesday in a conference call organized by the Economic Policy Institute described the potential effect on their states if the Medicaid aid extension package is not approved by the Senate, CQ HealthBeat reports (Norman, CQ HealthBeat, 6/9).
A substitute amendment offered by Senate Finance Committee Chair Max Baucus (D-Mont.) on Tuesday would restore about $24 billion in additional federal Medicaid assistance to states through June 2011.
The provision would extend funding allocated in the 2009 federal economic stimulus package that is scheduled to expire in December (California Healthline, 6/9). The House-approved bill omitted the Medicaid aid package to mollify members of the Democratic House Blue Dog Coalition who had concerns with the bill's cost.
During the conference call, the governors of Kansas, Pennsylvania, Washington state and Wisconsin said that dozens of state legislatures already had factored the new Medicaid funding into their fiscal year 2011 budgets (McCarthy, CongressDaily, 6/10). They also noted that the loss of funds would force states to make cuts in their budgets that could affect millions of residents (CQ HealthBeat, 6/10).
In addition, they said that thousands of workers could lose their jobs and that states would have to raise taxes and other fees to balance their budgets (Lambert, Reuters, 6/9).
Meanwhile, more than 400 members of the American Health Care Association and the National Center for Assisted Living, which represents nursing homes and assisted living facilities, made visits to lawmakers on Capitol Hill to encourage them to support the new Medicaid funding package (CQ HealthBeat, 6/9).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.