Senate
Approves SCHIP Reauthorization
Yesterday, the Senate approved S. 275, which reauthorizes the State
Children's Health Insurance Program (SCHIP) for four-and-a-half years and
spends an additional $32.8 billion. The bill would provide health
insurance for children in families who earn under 300%
of the federal poverty level but too much to qualify for Medicaid. Although the
House passed its reauthorization (H.R. 2) on January 14, House Speaker Pelosi
said that the House would take up the Senate bill next week. The two versions
are similar,but the Senate
version removes the five-year waiting period for coverage of legal immigrant
pregnant women and children, and creates a payment advisory commission on
Medicaid. The Senate bill also wouldallow states to
provide dental benefits as a wrap-around service for children enrolled in
private coverage. The Senate bill would give states the option of documenting
an applicant's citizenship at the time of application or later, through the
applicant's Social Security number.
House
Passes Stimulus Bill
Yesterday, the House passed an $819 billion economic
stimulus bill (H.R. 1) that contains $275 billion in tax cuts and almost $545
billion in domestic spending. It would direct more than $300 billion in
aid to states to help rebuild schools, provide health care to the poor, and
reconstruct highways and bridges. Specific to transportation, the House passed
by voice vote an amendment to increase transit funding by $3 billion, bringing
the total for transit funding in the bill to $12 billion.
House Fails to Pass Digital TV Delay
Yesterday, the House failed to pass a bill (S. 328) to delay the digital
television (DTV) transition date from February 17 to June 12, 2009. House
leaders will consider whether to take the bill to the House Rules Committee for
a rule for debate. This would allow the House to reconsider the bill for
passage by a simple majority. The
Senate passed its version on Monday.
Senate
Votes to Delay Digital TV Transition
The Senate voted Monday to extend the digital television transition date from
February 17 to June 12, 2009. The bill, S. 328, parallels a House bill
that was scheduled for markup last week. House Energy and Commerce Committee
Waxman is expected to seek a vote this week.
CBO Releases House Stimulus Cost Estimate
The Congressional Budget Office (CBO) released its cost estimate of H.R. 1, the
American Recovery and Reinvestment Act of 2009. CBO estimates the bill will
cost the federal government $170 billion in FY 2009, $356 billion in FY 2010
and $174 billion in FY 2011. A copy of the report is available at http://cbo.gov/ftpdocs/99xx/doc9968/hr1.pdf.
GAO Releases Update on
The Government Accountability Office (GAO) released its Update of State and
Local Government Fiscal Pressures. GAO prepared the report to inform
Congress of the fiscal pressures facing state and local governments and
principles
to consider in determining how to effectively target temporary assistance to
states, especially for Medicaid. The report is available at http://www.gao.gov/new.items/d09320r.pdf.
Comment Period Announced for Fostering Connections to Success and Increasing
Adoptions Act
The Department of Health and Human Services (HHS) Administration for
Children and Families (ACF) published in the Federal Register a request
for public comment related to implementation of the Tribal Title IV-E plan as
authorized in the Fostering Connections to Success and Increasing Adoptions Act
of 2008 (P.L. 110-351). The law, as amended, permits federally recognized
Indian tribes and tribal organizations to operate a title IV-E program in the
same manner that states are currently permitted, beginning October 1,
2009. Information concerning the request for public comment and
opportunities for tribal consultation can be accessed at http://edocket.access.gpo.gov/2009/pdf/E9-1338.pdf.
All written comments must be received on or before April 27, 2009.
CMS Publishes Medicaid DSH Allotments
In yesterday's Federal Register, the Centers for Medicare & Medicaid Services
(CMS) published the final state allocationsfor
Medicaid Disproportionate Share Hospital (DSH) payments for FY 2009. The notice
can be viewed at
http://frwebgate3.access.gpo.gov/cgi-bin/PDFgate.cgi?WAISdocID=06631720261+5+2+0&WAISaction=retrieve.
CMS Reopens Comment Period on Medicaid Options for Premiums
and Cost Sharing
Today, CMS published a notice in the Federal Register that delays for 60
days the effective date of the final rule regarding premiums and cost sharing
for certain enrollees. The final rule (73 FR 71828), originally published
November 25, 2008, implemented provisions of the Deficit Reduction Act of 2005
and the Tax Relief and Health Care Act of 2006, providing state Medicaid
agencies increased flexibility to impose premium and cost-sharing requirements
on certain Medicaid recipients and address cost sharing for non-preferred drugs
and non-emergency care provided in a hospital emergency department. Comments
are due on February 26, 2009.
House
Democrats Propose Economic Stimulus
Yesterday, House Democrats unveiled an $825 billion spending and tax plan to
spur economic growth. The $550 billion spending portion of the bill includes
about $318 billion for state and local governments, including $87 billion for a
temporary increase in the Medicaid matching rate. Food stamp benefits
would increase by 13% and $36 billion is included to extend and expand
unemployment benefits. The infrastructure portion includes $30 billion for
highway construction, $10 billion for mass transit and rail and $19 billion for
clean water, flood control and environmental restoration projects. House
leaders said they plan to consider the package in committee next
week.
FFIS is currently analyzing the proposal. Of note, the specifics surrounding
Medicaid have not yet been released, pending a final score from the
Congressional Budget Office. FFIS has been told that the 4.8% FMAP increase
that was included in summaries of the proposal may not be the final figure.
Senate Finance Approves SCHIP Proposal
Yesterday, the Senate Finance Committee approved a proposal to reauthorize
the State Children's Health Insurance Program (SCHIP). The proposal would
increase funding by $31.5 billion over four and a half years and make changes
to the state allotment formula. It would phase out SCHIP coverage for childless
adults and parents. The additional funding is offset through an increase in
tobacco taxes. The committee approved several amendments, including one that
would remove the five-year waiting period in the current law and give states
the option to provide SCHIP
coverage to low-income, uninsured, legal immigrant children and pregnant women
who have been in the United States for less than five years. Similar language
was included in the House-passed bill earlier this week (H.R. 2). The committee
also approved an amendment that would give states the option to allow children
who lack dental coverage in their private health insurance to receive dental
coverage through SCHIP, without dropping their private plan. Other amendments
were accepted that require states to check on legal immigrants' status so that
those with expired visas do not participate in the program and to define a
"school-based health center." The bill is expected to be considered
by the full Senate this month.
HHS Delays ICD-10 Implementation
Yesterday, the Department of Health and Human Services (HHS) issued a final
regulation that would give health care plans and providers until October 2013
to adopt a new health care coding system, the International Classification of
Diseases,
Tenth Revision (ICD-10). Previously, HHS had proposed that the new system be
adopted by October 2011. HHS also issued a related final rule updating
standards for electronic health care transactions under the Health Insurance
Portability and
Accountability Act (HIPAA). According to the Centers for Medicare &
Medicaid Services (CMS), HIPAA "covered entities" such as health
plans, health care clearinghouses and certain health providers must begin using
the updated standard on January 1, 2012. Small health plans must comply on
January 1, 2013. The final rules are scheduled to be published in the January
16 Federal Register. A fact sheet is available at:
http://www.cms.hhs.gov/apps/media/press/factsheet.aspCounter=3407&intNumPerPage=10&checkDate=&checkKey=&srchType=1&numDays=3500&srchOpt=0&srchData=&keywordType=All&chkNewsType=6&intPage=&showAll=&pYear=&year=&desc=&cboOrder=date
House
Stimulus Details May be Released Today
The House of Representatives announced details of its
economic recovery bill today.
The $850 billion package of tax cuts and spending provisions will be considered
by the relevant House committees next week. The proposal includes $85 billion
for infrastructure, $80 billion for state education programs and $90 billion
for
Medicaid. A summary of the proposal can be found here.
House Passes SCHIP Bill; Senate Finance Committee Scheduled
to Consider Proposal
Yesterday, the House passed the Children's Health Insurance Program
Reauthorization Act of 2009 (CHIPRA, H.R. 2). The bill would increase
funding by about $33 billion over four and a half years through September 30,
2013. It is estimated to provide coverage for an additional four million
children. The measure resembles proposals considered during the previous
Congress. It removes the five-year waiting period for coverage for legal
immigrant children, adds new options to allow states to comply with existing
Medicaid citizenship documentation rules and applies this citizenship
requirement to SCHIP. The House bill is funded by a 61-cent increase in the
tobacco tax and through provisions affecting physician-owned hospitals.
The Senate Finance Committee is scheduled to consider SCHIP reauthorization
today. The proposal resembles the House-passed legislation. Several amendments
are expected to be offered during the committee meeting, addressing coverage
for legal immigrant children, funding and citizenship documentation
requirements.
The Congressional Budget Office cost estimate for H.R. 2 is available at
http://www.cbo.gov/ftpdocs/99xx/doc9963/hr2.pdf.
The Senate Finance Committee proposal information is available at
http://finance.senate.gov/press/Bpress/2009press/prb011309.pdf.