Reid Seeks To Restore Medicaid Assistance to ‘Extenders’ Bill
On Monday, Senate Majority Leader Harry Reid (D-Nev.) said that he wants to restore a provision in the so-called "extenders" bill (HR 4213) that would provide nearly $24 billion in additional federal Medicaid funds to states beyond 2010, CQ Today reports (Rubin, CQ Today, 6/7).
The 2009 federal economic stimulus package provided $87 billion in extra Medicaid funding to states through Dec. 31. The provision in the original extenders bill would have continued aid through mid-2011.
The House, which approved the extenders bill on May 28, omitted the provision in an effort to secure enough votes for passage by alleviating members' concerns over the bill's cost (California Healthline, 6/4).
The Senate, which reconvened on Monday after the weeklong Memorial Day recess, is expected to take up the bill this week.
Reid on Monday did not specify whether he would restore the full $24 billion Medicaid package or a modified version, CQ Today reports. Any Senate changes to the legislation would send the bill back to the House for a revote (CQ Today, 6/7).
House Speaker Nancy Pelosi (D-Calif.) last week indicated that the House would be open to reconsidering the provision (Sack, New York Times, 6/7).
Restoring Funds Could Complicate Passage in Senate
Restoring the omitted Medicaid funding could complicate the challenge Reid and Senate Democrats face in passing the extenders bill, CQ Today reports. According to CQ Today, at least two groups of senators have expressed concern about the bill that the House approved.
The first group expressed concerns regarding offsets in the bill that they feel would negatively affect business and private equity firms and enterprises.
The second group -- made up of moderate Democrats and Republicans -- has expressed concern about the effect of the bill on federal deficit. The House-passed version of the bill already is projected to increase the deficit by $54.2 billion over 10 years (CQ Today, 6/7).
State Officials Begin Lobbying Congress
Officials from at least 30 states were "caught largely by surprise" when the House eliminated the Medicaid assistance package, the Times reports.
Many state governors and legislators were so confident of the funding extension -- largely because the funding had been included in separate bills over the past 10 months and was part of President Obama's 2011 budget proposal -- that they factored it into their new budgets.
As a result, many states have a large stake in whether the federal Medicaid funds are restored. Failure to restore the funds could result in large-scale cuts or new taxes in states currently struggling to balance their budgets, the Times reports.
California Seeks Restoration of Medicaid Funding
California is among the states that were relying on the additional Medicaid funds as part of their budget plans.
Gov. Arnold Schwarzenegger's (R) latest budget proposal assumed the state would receive $1.5 billion in increased federal aid for Medi-Cal, California's Medicaid program (New York Times, 6/7).
Schwarzenegger has joined 46 other governors in urging the Senate to restore the funding (Lochhead, San Francisco Chronicle, 6/8).
In a letter sent last week to California's congressional delegation, Schwarzenegger called the Medicaid funds "critical to California" and said the elimination of the extension would be "cruel and counterproductive."
He warned that "cutting the only funding designed to help states maintain the very safety net programs Congress mandates us to preserve will have devastating consequences" (Office of the Governor release, 6/4).
'Doc Fix' Issue Threatens Access to Care for Medicare Beneficiaries
Meanwhile, Congress' failure to address the 21% cut to physicians' Medicare payments in the extenders bill already has some physicians reconsidering serving Medicare beneficiaries or accepting new beneficiaries. According to CQ Today, some physicians are considering leaving the program altogether (Ethridge, CQ Today, 6/7).
The House-approved extenders bill would delay until 2012 a 21% cut to physicians' Medicare payments. Until then, the payment rates would increase by 2.2% for the remainder of 2010 and by 1% in 2011. The Senate adjourned for the Memorial Day recess before it could take up the legislation, causing the scheduled cut to take effect on June 1 (California Healthline, 6/1).
According to CQ Today, physicians say they feel betrayed by Democrats for failing to develop a permanent solution to the payment formula in return for their support for the new health reform law.
Physician groups note that if their members decide to limit or halt services for Medicare beneficiaries, access to care could be compromised. Further, that scenario could undermine the success of the new health reform law, which largely depends on the availability of physicians (Ethridge, CQ Today, 6/7).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.