Senate Under Pressure as it Considers Changes to 'Extenders' Legislation

TOPIC ALERT:

As the Senate returns from its Memorial Day recess, progress on the so-called "extenders" bill could be slow because Democrats in the chamber will evaluate several late changes to the legislation made by the House, CQ Today reports.

The legislation, which recently passed in the House, would extend a series of expiring unemployment and tax benefits and delay until 2012 a 21% cut to physicians' Medicare payments (Rubin, CQ Today, 6/4).

House Changes

The House Democratic leadership won passage for the bill before the recess by eliminating about $31 billion from the $145 billion package.

Party leaders cut extensions of COBRA subsidies for unemployed workers and an extension of additional state Medicaid funding outlined in the 2009 federal economic stimulus package, worth about $23 billion.

The revised bill also would increase physicians' Medicare payment rates by 2.2% for the remainder of 2010 and by 1% in 2011, before the payment formula would revert to the current formula in 2012 (California Healthline, 5/28).

Senate Action

According to CQ Today, the Senate must assess the House changes and secure at least one Republican vote. However, disagreements among Democrats might also hold up progress on the legislation.

One group of Democratic senators, including Kent Conrad (D-N.D.) and Ben Nelson (D-Neb.), is expected to seek changes that would further reduce the bill's effect on the deficit, perhaps by cutting certain benefits. Other Democrats might hinder progress by seeking alterations to certain tax provisions in the bill (CQ Today, 6/4).

Under Pressure

As they consider the legislation, Senate Democrats face pressure from various groups that have a stake in the bill's final form, The Hill reports.

State officials are lobbying lawmakers to extend for six months the $23 billion in additional state funding for Medicaid that the House eliminated. State advocates said that without the extra federal funds for the program, states will have to raise taxes, reduce social spending or make cuts to their Medicaid programs.

Groups including Families USA are seeking for lawmakers re-insert an extension of the 65% COBRA subsidy for people who lose their jobs (Pecquet, The Hill, 6/6).

Lawmakers also will face extensive lobbying from physicians, who are urging senators to prevent the Medicare payment cut by quickly passing the bill. Physicians also are continuing to push for a long-term fix to the payment formulas (Pecquet, The Hill, 6/5).

Editorial

"The formula that is used to pay doctors who treat Medicare patients is producing increasingly absurd results," a New York Times editorial states.

The editorial continues, "There will likely be no real solution" to the schedule payment cuts "until the American health care system moves away from unfettered fee-for-service payments that encourage doctors to perform unnecessary and costly tests and procedures and pays them instead for better management of a patient's care" (New York Times, 6/4).

to share your thoughts on this article.