Week In Review: Doctor Payment Fight; State Budgets And Medicaid; Medicare Brochure Protests

Democrats, who have managed to push sweeping health and financial reform bills through Congress in recent months, ran into a buzzsaw this week on a wide-ranging jobs bill that among other things would have extended subsidies for COBRA health insurance for laid-off workers and provided states with extra money to cover Medicaid. The bill also ended the threat of a cut in Medicare reimbursements for doctors.

Bowing to pressure from fiscal conservatives to cut spending, House leaders dropped both the COBRA subsidy extension to help newly laid-off pay for health coverage as well as more federal aid to boost state Medicaid budgets, The Associated Press reported.

The House did approve a $22 billion, 19-month fix for the Medicare payments to doctors. Politico noted that without that fix, doctors would have faced a 21 percent reduction in payments beginning June 1. Although several programs covered by the bill will expire during the congressional recess that begins this weekend, final action isn’t expected because until the Senate takes up the bill after June 7. 

The Washington Post said the House may consider the COBRA subsidy and Medicaid payments when members return in June. For many states, the Medicaid funding will be critical. CNN Money reported that about 20 states “have already assumed those [Medicaid] funds in their fiscal 2011 budgets. If it doesn’t come through, they’d have to make even more massive cuts to balance their budgets.”

KHN provided more coverage of the bill (5/28).

Meanwhile, House Republicans this week vigorously criticized a new Medicare brochure distributed by the Department of Health and Human Services. Senate Republican leader Mitch McConnell “took offense to the flyers for saying the new law will ‘preserve and strengthen’ Medicare,” The Hill reported. “And he pointed out that the Department of Health and Human Services lambasted private Medicare Advantage plans when they used similar communications to their members to raise concerns with the health reform law before it was passed.”

The Obama administration and congressional Democrats rejected the criticism. House Speaker Nancy Pelosi said, “One of our top jobs is to clear up confusion and correct misinformation about health reform. This brochure . . . is a good place to start.” And HHS Secretary Kathleen Sebelius said, “At the Department of Health and Human Services, it’s our responsibility to get the word to seniors about what the facts are involving this critical benefit program,” according to The Washington Post. 

KHN published the full text of the brochure.

House Republicans also introduced a bill to repeal the new health law, The Hill reported Thursday. With solid Democratic majorities in both the Senate and House, the bill appeared to have little chance of getting to a vote.

Meanwhile, several new reports on the health overhaul’s implications came out this week. In one, 661 businesses were surveyed by the consulting firm Towers Watson and 94 percent of them said that the new law “will raise costs,” The Associated Press reported. “Eighty-eight percent plan to pass the increases on to employees, and 74 percent anticipate reducing health benefits and programs.”

A second report, from the Kaiser Commission on Medicaid and the Uninsured, found that despite complaints from some states about the the burden of expanding health care to millions of poor Americans under the new law, “states are likely to reap huge benefits for relatively little cost, and may even end up in the black” The Fiscal Times reported. Provisions of the health care law, which begin in 2014, will expand the program’s eligibility to adults with incomes of less than 133 percent of the federal poverty level. “That’s expected to add 15.9 million people to the Medicaid ranks by 2019, at a cost of $465 billion, though only $21 billion would come from states.” 

KHN’s May 27 “Morning Edition” has full coverage of the study, including the impact on individual states. (KHN is a project of the Kaiser Family Foundation.) 

A report from the National Institute for Health Care Reform, a research group funded by automakers and the UAW, found that a “$5 billion fund to create high-risk pools in the states as part of the health overhaul may fall short of meeting the needs of uninsured people with health problems if state and federal officials closely monitor the program,” KHN staff writer Christopher Weaver reported. “As many as 7 million people have been uninsured for an extended time because of their health conditions, make too much for safety net programs such as Medicaid and have not qualified for existing state-financed risk pools,” but “the money could cover as few as 200,000 people unless states take actions to stretch the money further.”

Congress also took note this week of a glitch in the health law’s treatment of families insured by the military’s Tricare program: They will not be able to keep children on their plans until age 26 (Americans covered by most civilian policies will have that provision), according to The Washington Post reported. Before the overhaul passed, military families were assured that the legislation would not “negatively impact” Tricare and the program was left untouched. But now, some families are disappointed. “It seems discriminatory to those of us who have military benefits for which we are paying,” one retired officer said. That’s why lawmakers are hoping to tack a provision onto the defense authorization bill that would expand that and other health overhaul benefits to military families.

Meanwhile, the Obama administration this week asked a “federal judge to toss out Virginia Attorney General Ken Cuccinelli’s lawsuit challenging federal health-care reform,” the Richmond Times Dispatch reports. “Cuccinelli’s suit argues that by including the mandate, Congress overstepped its authority under the Commerce Clause in Article 1 of the U.S. Constitution.”

The May 25 Morning Edition offers more coverage of this issue.

Finally, USA Today reported this week that “a federal law that President Obama signed early last year to expand health insurance to 4 million more low-income children has gotten off to a slow start because of budget problems in the states. The law makes more than $10 billion in federal aid available each year through 2013 but requires state funds as well.”