Friday, January 16, 2009

Capitol Hill Watch

House Democrats Announce $825B Economic Stimulus Package With $157B for Health Care

      House Democrats on Thursday announced a two-year, $825 billion economic stimulus package that includes more than $157.5 billion for health care programs, CQ HealthBeat reports (Carey/Attias, CQ HealthBeat, 1/15). The package includes a provision that would provide $87 billion to increase temporarily federal funds for state Medicaid programs (Herszenhorn, New York Times, 1/16). In addition, the package includes funds for a provision that would allow low-income workers who lose jobs that did not include health insurance to apply for Medicaid through 2010 (Wayne, CQ Today, 1/15).

The package also includes a provision that would provide $39 billion in federal subsidies for COBRA -- which allows recently laid-off workers to retain their group health insurance, provided that they pay 102% of the premiums (Hall/Lightman, McClatchy/Miami Herald, 1/16). Under the provision, workers who lost their jobs and their health insurance after Sept. 1, 2008, could receive subsidies to cover the cost of two-thirds of their premiums under COBRA (Taylor, AP/Philadelphia Inquirer, 1/16). The package also includes a provision that would extend the period of time recently laid-off workers ages 55 or older could retain their health insurance under COBRA (McClatchy/Miami Herald, 1/16).

The package also includes provisions that would provide $20 billion for health care information technology and $1.1 billion for comparative effectiveness research conducted by the Agency for Healthcare Research and Quality.

Other Health Care Provisions
Other provisions in the economic stimulus package related to health care spending include:

• $550 million to modernize technology at Indian Health Service hospitals and health care facilities;
  
  
• $3.75 billion for construction of new Department of Defense health care facilities and $455 million for renovations of such facilities;
  
  
• $950 million for repairs and renovations of Department of Veterans Affairs health care facilities (CQ HealthBeat, 1/15);
  
  
• $2 billion for renovations at NIH facilities and new agency research grants and $1.5 billion for renovations at university laboratories that conduct research sponsored by the agency;
  
  
• $3 billion to promote preventive care and wellness programs;
  
  
• $1.5 billion for renovations and expansions of community health centers;
  
  
• $600 million to train primary care physicians who agree to enter the National Health Service Corps;
  
  
• $900 million for research into an experimental pandemic flu vaccine and countermeasures for potential chemical and biological attacks; and
  
  
• $462 million for construction and renovations of CDC facilities (CQ Today, 1/15).

Prospects for Passage
House Speaker Nancy Pelosi (D-Calif.) and Senate Majority Leader Harry Reid (D-Nev.) said that they seek to complete work on the economic stimulus package before the Presidents Day recess. The House Appropriations Committee and the House Ways and Means Committee plan to hold mark ups on the package next Thursday, with the House scheduled to vote on the package on Jan. 28. The Senate plans to consider the package during the first week in February. According to the Washington Post, Senate Democrats have said that that their "stimulus wish list" could include many provisions not included in the House version of the package and cost as much as $900 billion (Murray/Kane, Washington Post, 1/16).

Reaction
According to the New York Times, the package announced by House Democrats "emphasized mostly Democratic principles," such as "helping the unemployed pay health care costs," and raised concerns from Republicans (New York Times, 1/15). House Minority Leader John Boehner (R-Ohio) said that the package appears to "be grounded in the flawed notion that we can simply borrow and spend our way back to prosperity" (Bendavid et al., Wall Street Journal, 1/16). House Appropriations Committee ranking member Jerry Lewis (R-Calif.) said, "This legislation appears to blanket government programs in spending with little thought toward real economic results, job creation or respect for the taxpayer" (Dennis/Kucinich, Roll Call, 1/15).

Paul Ginsburg of the Center for Studying Health System Change said of the provisions in the package related to COBRA, "That is a pretty dramatic health policy step to address the difficulty some near-elderly have in getting health coverage" (USA Today graphic, 1/16).

Robert Bixby, executive director for the Concord Coalition, said, "These may be worthwhile things like health care, technology and scientific research," but "these are all things that require some long-term strategy." He added, "I question whether shoveling money out the door in a stimulus bill is the way to do it" (Hook/Puzzanghera, Los Angeles Times, 1/16).