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Dems 1 For 2 On Health Subsidies: House Poised To Vote On Extra Medicaid Funds But COBRA Help Likely Gone For Good

By Andrew Villegas

House lawmakers,Ìýalready more than a week intoÌýtheirÌýAugust recess,Ìýare returningÌýto Capitol HillÌýto act on aÌýproposal providing states with $16 billion in extra federal Medicaid assistance. The vote,Ìýscheduled for Tuesday, comes afterÌýSenate Democrats unexpectedlyÌýpassedÌýaÌýstate aid package last week, which alsoÌýincludes $10 billionÌýto preserve teaching jobs.

Extra Medicaid Funds Began With StimulusÌý

With states facing aÌýrecession double-whammy of less revenue and more demand for health care services, Congress included extra money to Medicaid programs in the February 2009Ìýfederal stimulus package. Before the stimulus, the federal government’s share of Medicaid costs was between 50 and 76 percent (depending on the per capita income of the state).ÌýThe federal match increased to between 61 and 84 percent of all Medicaid spending. The higher matching rate was originally slated to expire at the end of 2010, but an early version of the jobs billÌýextended the funding another six months, at a cost of $24 billion.

Because officials were convinced the money was imminent, 29 states factored the extra money into their budgets for the fiscal year that ends June 30, 2011.

While elected officials,Ìýhospital groups and organizations like the ÌýpushedÌýhard for the six month extension, concerns about deficit spendingÌýkept the measure fromÌýbeing approved.ÌýIt was stripped from the House-passedÌýbill in late May. Democrats inserted it in theÌýSenateÌýversion,Ìýbut it failed to pass – three times. In June, Democratic leaders unsuccessfully floated a compromise approach that would have phased out the enhanced funding over six months.

Sen. Scott Brown, R-Mass., introduced a stand-alone bill that would offset the cost of the higher matching rate using stimulus funds, but Democrats opposed his approach, maintaining those funds are needed to support other jobs programs.

Governors from both parties argue that the current funding level is critical. Without it, they say theyÌýwill face budgetary crisesÌýthat will trigger state employee lay-offs and deep program cuts. SomeÌýstates – including Ìýand Idaho – are considering revisiting their budgets or tapping into reserve funds to cover the gap, according to a Ìýby the National Conference of State Legislatures, which endorses an extension of the enhanced Medicaid match.

COBRA Subsidy: Missing From Jobs BillÌý

Meanwhile, the prospects forÌýaction on what was once another Democratic health care priority are dimming. The COBRA subsidy provided newly laid-off workers with a 65 percent subsidy to help them stayÌýon their former employer’s health plan.Ìý

This assistanceÌýwas also authorized in last year’s stimulus bill and was extended three times, through the end of May,Ìýbut now,Ìýworkers laid off after June 1 aren’t eligible.ÌýTheyÌýstill have the right to stay onÌýtheir former employer’s health insurance plan for up toÌý18 months, but they must now pay the entire cost of the premium, an expense that is often prohibitive.

A new extension of the subsidy was initially included in the House jobs bill; but because of budgetary and political pressuresÌýconservative Democrats and Republicans forced theÌýleaders to jettison it. The provision was never in the Senate bill.

On June 24, Speaker of the House Nancy Pelosi “I am hard put to pass any more initiatives here unless there is some reasonable prospect of success on the Senate side.”

Sens. Bob Casey, D-Penn., and Sherrod Brown, D-Ohio, are attempting to advance the COBRA subsidy as a separate piece of legislation and would pay for it by eliminating a tax break. Under their plan, the COBRA assistance would be retroactive, giving people laid off since June 1 six months of the federal subsidy instead of the 15 months that the earlier law provided.

In late June,ÌýBrown that while the economy is showing signs of improvement, many workers don’t have access to affordable COBRA coverage. According to a spokeswoman from his office, heÌýremains hopeful that some type ofÌýextension will pass this year, though she wasn’t sure exactly what it might include. “With the Senate schedule still so in flux we’ll just be looking at any potential opportunity to move it. But nothing’s been nailed down yet,” she said.

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