by Alexandra Sange

This week the Senate will continue its consideration of the Extenders Bill that the House passed at the end of May.  Last week, Senate Majority Leader Harry Reid (NV) kicked off Senate consideration of the Extenders Bill with the introduction of the Senate’s version of the legislation – in the form of a manager’s amendment to the House bill that would strike it and replace it with a slightly modified bill.  The major change in the replacement Senate bill, introduced by Max Baucus (MT), is the re-inclusion of the FMAP extension from ARRA, which would extend the enhanced match rate another six months – through June 30, 2010 – and add another $24 billion to the cost of the total package.  Additionally, Senator Baucus’ substitute includes the preventive services payment clarification for health centers that is also in the House version, an SGR (Medicare physician payment) fix through the end of 2011, an extension of unemployment compensation, and an extension of the 2009 Federal Poverty Levels until 2011 levels are issued.

The Senate reinserted the FMAP extension in the Extenders Bill in response to calls from national and state advocates across the country: from governors to unions to health care organizations.  Since the House bill passed without the FMAP provision, these groups and other stakeholders have been very active pushing the Senate to reinclude the extension.  NACHC has been working with the Medicaid Coalition, the Partnership for Medicaid and others to emphasize the importance of this extension in stabilizing state budgets.  Many Senators, including Senators Collins and Snowe of Maine (key votes needed for final passage of the bill on the Senate floor), have expressed strong support for the FMAP provision.  However, both the cost of the underlying bill and some of the proposed offsets to that cost continue to be the subject of much debate and negotiation amongst Senators on both sides of the aisle.

The Senate has already started debate on the Extenders Bill, which will go through this week to give members on both sides of the aisle a chance to propose additional amendments, and give leadership time to lock down the sixty votes needed for final passage.  Debate will begin in earnest on Monday and a vote to invoke cloture and end debate could happen as early as Wednesday, but there will be many amendments that come up in the meantime.  Amendments may be offered to lengthen the Medicare providers fix and to reinsert the COBRA extension the House removed from the bill, and many amendments have already been filed to delete or modify tax provisions.  Senate leadership is also prepared for amendments that modify the FMAP provision.  In addition, late last week Senator John Thune (SD) filed a GOP alternative to the Extenders Bill that would cut spending and reduce the deficit.  The Republican alternative does not include the FMAP extension.  All of the amendments will propose to modify Senator Baucus’  substitute amendment, which will need to go back to the House to pass for a vote once the Senate approves it.  We will continue to watch this closely and keep updating the blog as the Senate debates and possibly amends this important Extenders Bill.