[NYAPRS Enews] CD, CQ: Pressure Builds for Deal on Medicaid Enhancement Extension

[Harvey Rosenthal]

Dems Consider More Medicaid Cuts

by Peter Cohn, with Meghan McCarthy contributing, Congressional Daily pm
June 23, 2010

 

UPDATED--Senate Democrats continued today to negotiate with a few
Republicans to somehow snatch victory from the jaws of defeat on a
package of unemployment benefits, Medicare physician payments, tax
breaks and other items.

Discussions were ongoing at presstime, but in a new version circulating
it appears $24 billion in Medicaid funding for states could be cut by
roughly a third, through gradually phasing down percentage increases
from 6.2 percent to 3.2 percent, and then 1.2 percent.

Democrats were looking at using a mix of rescissions from untapped
stimulus funds and prior-year defense appropriations and other measures
to keep the size of the package below $100 billion. Senate Democrats
were mulling whether to press ahead and offer the new version as early
as this afternoon.

Majority Leader Reid would then file cloture, setting up a final vote no
later than Friday.

Target GOP votes remain Sens. Susan Collins and Olympia Snowe of Maine
and Scott Brown of Massachusetts.

Snowe has also raised concerns with a tax increase on small
privately-held services companies, which Democrats said they were
tinkering with as well. Democrats have already pared back the $11
billion measure to $9 billion, but losing more revenue would make the
underlying bill add more to the deficit.

Snowe also wants Democrats to remove a provision worth $400 million to
California hospitals, arguing it is a special deal for one state. But
the latest version preserves the California language, as well as the tax
increase on "S corporations."

Aides said Reid may press ahead anyway, even if he does not have all 60
votes immediately in hand. House Democrats are clearly losing patience.

"It needs to happen this week. We've had a million and a quarter people
who've lost their benefits," said House Ways and Means Chairman Sander
Levin, who discussed the "extender" bill with panel Democrats at a
meeting today. "We're past midnight, for the unemployed, for physician
reimbursements, for job creation. ... We need to act on this. No
excuses."

Levin said it was possible the Senate could put the "doc fix" language
back into the broader extender bill, which is now fully offset in
compliance with the GOP senators' wishes.

"I just think we ought to get something done fast," said House Energy
and Commerce Chairman Henry Waxman, who added that the House could pass
a broader bill with Medicaid funding included.

The House initially stripped the full $24 billion, six-month Federal
Medical Assistance Percentage extension due to Blue Dog cost concerns,
but if the Senate is able to whittle the overall cost down, that could
preserve Blue Dog votes.

Levin said he is consulting with Senate Finance Chairman Max Baucus on
what sort of extender bill could pass the House as well as the Senate.
But Levin laid the impasse clearly at the feet of Senate Republicans.

"The problem is the inability at this point of some Republicans to face
up to what in the lives of people is an emergency," he said. "The ball
is in the court of the Republicans in the Senate."

Levin said there were some changes that needed to be made with an offset
senators included to help pay for the six-month physician pay fix. The
measure would save $2.8 billion by giving companies more taxable income
by enabling them to spread out their pension obligations. The Senate
watered down income restrictions on firms accepting the relief, however,
and the

House wants the tougher language restored.

It would also provide some flexibility for multi-employer pension plans,
and House Democrats want to include some clarifying language important
to unions that participate in such plans, for example.

"I think it's generally recognized, broadly recognized that there have
to be some changes in the pension provisions," Levin said.

Levin said the Ways and Means panel would also continue to work on job
creation efforts, possibly including a renewable energy bill that would
expand tax credits for solar manufacturing facilities. He declined to
comment on whether reinstatement of the Superfund tax would be used to
offset the measure.

"We haven't discussed the pay-fors because the focus appropriately is on
the jobs bill. And nobody can escape it," Levin said.

----------------

 

Tax, Benefits Package in Limbo as Senate Awaits Budget Score

By Richard Rubin, CQ Staff   June 23, 2010

 

Democratic leaders kept the Senate in a holding pattern Wednesday as
they awaited the budget score for a new version of their tax and
benefits extensions bill.

Majority Leader Harry
<javascript:simplePopup('/find.do?dataSource=memberchild&queryFragment=(
S0561)%3cIN%3ememcodes%3cAND%3e(summary)%3cIN%3ememberreports&print=true
&sortSpec=displaydate+desc&productId=5','membercard',680,430);>  Reid,
D-Nev., said the first procedural votes to advance the new version could
occur as early as 4:30 p.m. To call up their new substitute amendment to
the bill (HR
<javascript:simplePopup('displaybillcard.do?billNumber=HR4213&congress=1
11&prod=5','billCard',680,430);>  4213), Democrats would have to table
the previous substitute and dispatch a Republican motion to refer the
issue to the Finance Committee. 

Democrats have not released the latest version of the bill and it's not
clear whether they can muster the 60 votes they will need to advance the
measure. It is also not clear whether they will introduce a new
substitute until they are assured of success. Their last attempt, on
June 17, fell four votes short because of concerns among moderate
Democrats and Republicans about the $55.1 billion that measure would
have added to the deficit.

They have been negotiating with Maine Republicans Olympia
<javascript:simplePopup('/find.do?dataSource=memberchild&queryFragment=(
S0372)%3cIN%3ememcodes%3cAND%3e(summary)%3cIN%3ememberreports&print=true
&sortSpec=displaydate+desc&productId=5','membercard',680,430);>  J.
Snowe and Susan
<javascript:simplePopup('/find.do?dataSource=memberchild&queryFragment=(
S0381)%3cIN%3ememcodes%3cAND%3e(summary)%3cIN%3ememberreports&print=true
&sortSpec=displaydate+desc&productId=5','membercard',680,430);>
Collins, with an eye to trimming enhanced Medicaid assistance to the
states that was provided in last year's stimulus law (PL
<javascript:simplePopup('displaylawcard.do?lawNumber=5&congress=111&prod
uctId=5','billCard',680,430);>  111-5) but is due to expire Dec. 31,
halfway through the fiscal year for most states. The House did not
extend the extra Medicaid funding in its version of the tax and benefits
package, which passed May 28.

In provisions circulating among lobbyists Wednesday afternoon, the
special Medicaid assistance would be pared back from the original $24.2
billion level and fully offset. 

The new version also includes more than $1.5 billion in rescissions of
previous spending, largely from procurement and research accounts at the
Defense Department. 

The latest version also retains provisions that would give companies
pension-funding relief and would reverse, through Nov. 30, a 21 percent
cut in
<http://www.cq.com/displayalertresult.do?matchId=104577734#keyword_0>
<Medicare payment rates to physicians. The Senate had pulled those
provisions out from the House-passed version of the extenders package
and passed them June 18 in a separate bill (HR
<javascript:simplePopup('displaybillcard.do?billNumber=HR3962&congress=1
11&prod=5','billCard',680,430);>  3962). But House Democratic leaders
have been reluctant to consider that measure until the Senate passes the
broader bill.

The core of the tax and benefits bill remains largely unchanged. It
includes an extension of unemployment benefits through November, a
one-year revival of tax breaks that expired at the end of 2009 and a
collection of spending on items from agricultural disaster assistance to
affordable housing.

Offsets would affect multinational corporations, investment managers who
earn money through "carried interest" and small professional services
corporations. That could remain a problem for Snowe, who said Tuesday
that she still had significant concerns about those provisions.

Source: CQ Today Online News 

 

 

 

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