Stimulus With Less Money for Medi-Cal Moves Closer To Vote
On Monday, the Senate voted 61-36 to end debate on the $838 billion economic stimulus package, which includes tens of billions of dollars for health care and other programs, McClatchy/Arizona Daily Star reports (Lightman, McClatchy/Arizona Daily Star, 2/10).
Three Republicans -- Sens. Arlen Specter (Pa.), Olympia Snowe (Maine) and Susan Collins (Maine) -- voted to close debate on the bill, providing Senate Democrats with the 60 votes needed to avoid a filibuster (Kane, Washington Post, 2/10). The vote cleared the way for the Senate to vote on the package on Tuesday (Pierce, Roll Call, 2/9).
Some Senate Republicans complained that their ideas were overlooked in formulating the package.
Senate Finance Committee ranking member Chuck Grassley (R-Iowa) said that he and other Republicans have been unable to offer amendments, including one that would place restrictions on the increase in federal aid to states for rising Medicaid costs (Herszenhorn, New York Times, 2/10).
If the legislation is approved, the Senate and House are expected to reconcile differences between the versions by Thursday and present each chamber with a final bill that will be briefly debated and voted on (McClatchy/Arizona Daily Star, 2/10).
Senate Majority Leader Harry Reid (D-Nev.) said, "There is no reason we can't do this by the end of the week," adding that if necessary he is willing to hold the Senate in session into the upcoming Presidents' Day recess (Espo, AP/Kansas City Star, 2/9).
Differences in Senate, House Packages
The Senate version of the economic stimulus package reworked a Medicaid funding formula to benefit rural states.Â
As a result, the bill would send $9.6 billion in additional federal Medicaid funding to California, according to Sen. Barbara Boxer's (D-Calif.) office.Â
California would have received $11 billion under the House bill.
Speaker of the House Nancy Pelosi (D-Calif.) and Boxer are working to revisit the formula to increase funds for California (Coile, San Francisco Chronicle, 2/10).
Other differences include:
- COBRA provisions: The Senate version includes $5 billion less than the House bill for federal COBRA subsidies. The Senate version also would provide a 50% subsidy for 12 months compared with 65% for nine months in the House version;
- Health information technology: Overall health IT spending is at about $19 billion in the Senate bill, compared with $20 billion in the House bill (Armstrong, CQ Today, 2/9). The Senate bill grants $3 billion in discretionary funds for the HHS Health IT coordination office (Noyes, CongressDaily, 2/10). Under the House version, $2 billion would be set aside for discretionary funding (Schatz et al., CQ Today, 2/9). In addition, the Senate version would cap at $1.5 million the amount that critical-access hospitals -- often those in rural areas that are in need of additional funding -- could receive to purchase health IT. The change "could set up a fight" between Senate and House lawmakers from rural areas, CQ Today reports;
- NIH funding: The Senate bill added $10 billion for NIH medical research and facility improvement (Armstrong, CQ Today, 2/9).
- Pandemic flu preparedness: The Senate recently stripped the $870 million for pandemic flu preparedness from its bill, while the House version still includes $900 million for flu;
- Prevention, wellness programs: The amended Senate package eliminated $5.8 billion set aside for grants and contracts for prevention and wellness programs -- such as health screenings, immunizations and nutrition counseling -- while the version passed by the House includes $3 billion for such programs (Schatz et al., CQ Today, 2/9); and
- Privacy protection: The House version of the economic stimulus package favors "strict protections [for electronic health records] advocated by consumer groups" that would expand a patient's right to know who is granted access to their health information, while the Senate "is poised to endorse more limited safeguards urged by business interests" and defer access issues to the HHS secretary, according to the Washington Post (Nakashima, Washington Post, 2/10).
Another area of contention is $1.1 billion for comparative analysis research included in both versions of the stimulus package, which the pharmaceutical, biotechnology and medical device industries are lobbying to have stripped or amended from the final bill, the Wall Street Journal reports.
The Partnership To Improve Patient Care -- which includes the lobbying bodies of the drug, device and biotech industries in addition to patient advocacy groups and medical professional associations -- is warning of a possible "slippery slope" where the government cuts useful treatments because of costs, according to the Journal. The Journal reports that the coalition is working to give the industries some say over what to research with the $1.1 billion (Mundy, Wall Street Journal, 2/9).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.