Alexandra Sange, MPP

For nearly a month now, Congress has been working to pass an Extenders Bill that a majority of members can agree on.  This week, both chambers will be facing tough choices on different fronts.  As we’ve been blogging, the so-called Extenders Bill is a comprehensive package of extensions to expiring programs including National Flood insurance, Build America Bonds, New Markets Tax Credits and much more.  The bill moved from the House, where it was pared down and passed, to the Senate where it has stalled due to concerns about the total cost of the legislation.  Last week, Senate Majority Leader Harry Reid held a vote to invoke cloture and end debate on Baucus’ Extenders Bill, but could not collect the necessary 60 supporters he needed to end a possible filibuster.  The vote tallied at 56-40, with Senators Ben Nelson (D-NE) and Joe Lieberman (I-CT) as the only two members who caucus with Democrats to vote no.  Senators Bond (MO), Byrd (WV), Graham (SC), and Roberts (KS) did not vote.

Over to the House – the Six-Month Medicare Physician Payment (SGR) Fix

Late Friday afternoon, however, the Senate did pass a stand-alone compromise bill from Senators Baucus and Grassley that would fix Medicare physician payments for the next six months and is completely paid for.  This compromise has now gone over to the House and Speaker Nancy Pelosi (CA) has stressed that it is imperative the Senate advance a larger Extenders Bill before the House considers passing a six-month Medicare physician payment (SGR) fix.  The House will likely take a wait-and-see approach as the Senate moves forward this week on the Extenders Bill and we’ll expect more news in the coming days.

Extenders (Still) in the Senate

Meanwhile, Senate Leaders have been working hard to pull together an extenders package that can pass the chamber and members have been giving floor speeches on the bill all week without taking any votes.  A “passable bill” would be one where the cost of the bill, especially the unpaid for part of the bill that will add to the deficit, is relatively low, and that the extensions it includes would bring relief to individuals and small businesses who are struggling in the down economy.  The Senate Democratic Leadership introduced a revised Baucus proposal late yesterday.  In this revised Extenders Bill, which includes an FMAP extension that phases out over six months, all of the provisions are completely paid for except the extension of unemployment insurance for a total cost of about $35 billion.  The bill also includes an extension of National Flood Insurance, a provision clarifying health center payment for Medicare preventive services, and extensions of New Markets Tax Credits and Build America Bonds.  Majority Leader Reid is bringing the revised Baucus bill to the floor today and aims to get the votes to pass it tonight and send it over to the House.  If leadership can’t get an agreement from 60 Senators, Senator Reid will hold a vote to invoke cloture and end debate tomorrow morning.  This is a bill we’ll be watching closely for all of the provisions that impact health centers and their patients, so keep checking back for more information.