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Competing Congressional Recovery Bills Contain Many Health Provisions

Members of both houses of Congress are busy putting together legislation that the President and congressional Democrats hope will lead the economy out of a recession. The bills in both the House and Senate (H.R. 1, S. 1) contain many health provisions.

The House bill includes provisions to overhaul the COBRA program, with the government subsidizing 65 percent of COBRA premiums for up to 12 months, and allowing people 55 or older with 10 years of tenure or more at their jobs to continue COBRA coverage until they find a new job offering health coverage or reach age 65 and are eligible to enter Medicare.

Rep. Cliff Stearns (R-Fla.) proposed an amendment during the Energy and Commerce markup that would bar COBRA participation for anyone with an income above $1 million. The amendment was passed by voice vote.

The bill would provide $20 billion for the creation of government standards for health information technology and the implementation of electronic medical records systems for public insurance programs, and monetary incentives for private hospitals and physicians to do the same.

The House bill would also provide $9 billion for states to expand Medicaid to cover low-income workers who lose their jobs through 2010, and $87 billion in increased Medicaid reimbursements to states to ease budget shortfalls.

The Senate bill contains almost identical provisions regarding the privacy of health records as the House bill, and would allocate a similar sum to encourage private hospitals and physicians to adopt electronic medical records systems.

Some disagreement arose in the Senate Finance Committee markup surrounding the disbursement of the $87 billion in extra Medicaid payments included in the bill. The original language would have provided 60 percent of the money as flat-rate increases in Medicaid reimbursements that would be constant for every state, with the other 40 percent of the money divided between states based on economic circumstances, meaning that states with more unemployed people receiving a larger share.

To the ire of some Democrats from larger states, an amendment by Sen. Jeff Bingaman (D-N.M.) was passed that changed the split between the two payment systems to 80 percent and 20 percent. Under the House version of the bill, the split between the two payment methods is 50-50.

Legislation approved by the Senate Appropriations Committee also includes $3.5 billion for the National Institutes of Health, $5.8 billion for preventive health activities, and $1 billion for construction and renovations at community health centers, which often provide basic health care for many of the uninsured.