Senate test vote today on bill to extend COBRA subsidy, doc fix and state Medicaid funding

The Senate is poised to consider a measure today that would include extending subsidies for COBRA benefits and unemployment insurance, prevent the Medicare payment cut for doctors and provide additional funding to state Medicaid programs.

The legislation "faces a key test vote in the Senate, its momentum helped by about 60 popular tax breaks for individuals and businesses that expired at the end of last year," The Associated Press reports. "All told, the measure would add $107 billion to the deficit over the coming decade. Democrats have labeled most of the bill an emergency measure, exempting it from stricter budget rules enacted just last month." In order to pass the measure, "Democrats need to muster at least one Republican vote Tuesday to reach the 60-vote threshold needed to limit debate and guarantee an up-or-down vote. But Sen. Susan Collins, R-Maine, provided crucial help last week to keep the measure out of another procedural tangle, and Democrats sound confident they will prevail" (Taylor, 3/9).

CQ Politics: The COBRA subsidy "was meant to be temporary, but it appears that it could outlast the Obama administration's proposal to remake the nation's health care system for future decades. In other words, if the Obama plan collapses, COBRA subsidies are likely to remain among the flotsam and jetsam of 'incremental' solutions left behind. … Current law provides subsidies for nine months to people who were laid off between Sept. 1, 2008 and Dec. 31, 2009. The 65 percent subsidy leaves them to pay only 35 percent of the monthly premium costs. Congress has expanded the program and extended it twice. And lawmakers are ready to extend it again" (3/8).

Modern Physician: "A bold pledge from [Health and Human Services Secretary Kathleen Sebelius] to resolve Medicare's physician payment problem has yet to convince all doctors that a permanent fix will ever be realized." The 21.2% cut, which went into effect on March 1, was "lifted by an emergency measure signed by President Barack Obama the following day." But "physicians were nevertheless angered by the fact that the measure—which provided a series of short-term extensions to various Medicare programs, including a 30-day stopgap on the SGR cut—fell woefully short of providing a long-term solution to this issue. … Federal actuaries and others have estimated it would cost $210 billion to $230 billion over 10 years to permanently repeal the SGR" (Lubell, 3/8).

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This article was reprinted from khn.org with permission from the Henry J. Kaiser Family Foundation. Kaiser Health News, an editorially independent news service, is a program of the Kaiser Family Foundation, a nonpartisan health care policy research organization unaffiliated with Kaiser Permanente.