Dems may add health provisions - including COBRA subsidies and Medicare fixes - to jobs bill

Feb 8 2010

Lawmakers may include a number of Medicare "fixes" in the jobs bill, now that the health overhaul bill has stalled, The Hill reports. They would include restoring Medicare provisions that expired Jan. 1 or are set to expire later this year. "Nursing homes and rehabilitation therapy providers, along with patient groups, are pushing legislation to undo a hard-dollar cap on Medicare coverage of physical, speech and occupational therapy. Hospitals are seeking to restore special payments to large rural and small urban hospitals. Physicians also are pursuing the reinstatement of bonuses to rural doctors. Doctors are also clamoring for action to prevent a 21 percent cut in their Medicare payments that looms March 1." Senate Finance Committee Chairman Max Baucus, D-Mont., is preparing an "extenders" package to deal with the issues, and the House Ways and Means Committee is drafting its own extender (Young, 2/7).

The physician's change may be possible because of an exception to Congress's new "pay-as-you-go" rules, McKnight's reports. The exception allows "Congress to delay a pay cut for [Medicare] physicians for a number of years without necessarily taking money away from other areas of spending." The pay-go rules, meant to help Congress balance the federal budget, require new spending to be accounted for with savings elsewhere (2/8).

An extension of federal subsidies to help laid-off workers pay for COBRA health benefits could find its way into the jobs bill, too, Business Insurance reports. The COBRA extension was in the president's budget, released last week. And, Baucus and Senate Majority Leader Harry Reid, D-Nev., "and several other top Senate Democrats last week distributed a description of a soon-to-be-introduced jobs bill that would include extending the COBRA subsidy, but provided no specific details. One proposal under discussion, sources said, would extend the subsidy another three months so employees laid off in March, April and May would be eligible. ... The availability of the subsidy has sent COBRA opt-in rates soaring. In a survey of 200 large employers, Hewitt found that the percentage of laid-off employees opting for COBRA more than doubled to 39% from March 1, 2009, when the subsidy generally first became available, through Nov. 30, 2009" (Geisel, 2/8)