by Alexandra Sange
Last Friday, just before they left for Memorial Day Recess, the House passed a scaled back version of the so-called Extenders Bill (HR 4213) that we’ve been following. However, the version the House passed (which will go to the Senate when they come back from recess next week) underwent several changes to keep the cost of the bill down. The enhanced FMAP extension was eliminated, as was the extension of COBRA subsidies for health insurance, and the Medicare SGR fix, or so-called “doc fix,” was shortened to stave off payment cuts only through the end of the 2011 before requiring additional Congressional action. In all, the cost of the bill went down by about $31 billion for a total cost of just over $110 billion (about half unpaid for), which was enough of a cost-reduction to garner the necessary votes for the House to pass the bill 215-204. Most of the provisions the pared-down Extenders Bill would extend expire today – June 1st – so the Senate will probably act relatively quickly to bring the bill to the floor once they return from recess next week.
The Extenders Bill also includes a provision that improves health center preventative service payments under Medicare (See Susan Sumrell’s more detailed blog post on this provision here).
More on the FMAP
One of the key changes was the elimination of the FMAP extension, which would have extended the enhanced Medicaid match rates states have been getting as a result of the American Reinvestment and Recovery Act. This enhanced rate is scheduled to end on December 31st, 2010 and states and health advocates across the country have been encouraging Congress to pass an extension of the enhanced rate to stabilize state budgets and Medicaid programs for several months. Many states have already included the extension in their budgets for the coming year and there is a strong understanding among Members of Congress that states will need a temporary extension of the enhanced Medicaid match rate to ensure states’ fiscal houses are in order. However, extending the enhanced rate through June 30th, 2011 (another six months) will cost the federal government $24 billion, requiring a sizable offset. Congress will continue looking for revenues to offset the cost of the FMAP extension and we can expect to see more activity, advocacy and ultimately action on this issue before the enhanced rate expires at the end of the year.