Bioterrorism, COBRA Among New Health Policy Issues Considered After Terrorist Attacks, CQ’s Goldreich Says

Congress is starting to resume work on "routine" health issues following the Sept. 11 terrorist attacks on the World Trade Center and Pentagon, but legislators' increased focus on national security also creates new health policy concerns, such as bioterrorism, Congressional Quarterly senior reporter Samuel Goldreich says in this week's "Congressional Quarterly Audio Report." Goldreich weighs in on several health policy issues, including the following:

• Bioterrorism: Combatting biological terrorism is likely to be among the responsibilities of the new Office of Homeland Security, created last week by President Bush. Goldreich predicts federal agencies such as the CDC and NIH, as well as state and local officials, will face "turf battles" as new procedures are determined. Sens. Edward Kennedy (D-Mass.) and Bill Frist (R-Tenn.) have asked Bush to earmark $1 billion to address bioterrorism and other health concerns. But so far, only a "tiny fraction" of post-attack spending is going to health care: Of the first $5 billion from the $40 billion emergency spending bill appropriated by Congress, the White House has allocated just $126 million to HHS (see story 5).
• COBRA: Also under new scrutiny in the wake of the attacks are COBRA benefits, which currently permit workers who leave or lose their jobs to maintain employer-sponsored health coverage for up to 36 months in some cases. Because COBRA regulations make the unemployed responsible for the entire premium, Goldreich notes, the benefit "isn't used much." Last week, however, "Democrats tried to sweeten" the benefit for laid-off airline workers as part of a $15 billion industry bailout package passed Sept. 21. Though the plan -- which would have extended COBRA for airline workers to 78 months and included a federal premium subsidy -- failed to pass, Goldreich reports that congressional leaders say a "separate bill on COBRA and unemployment benefits for airline workers could be considered as early as this week." He also predicts that COBRA could "emerge as an even bigger issue" if Congress considers a new economic stimulus package.
• Medicare: Though Congress "seems to be returning to some semblance of normalcy," any Medicare reforms this year "will be with a small 'r,'" Goldreich says. House Ways and Means Chair Bill Thomas (R-Calif.) is expected to unveil a bill in October that would include issues such as "health provider regulatory relief, strengthening Medicare's power to hire payment contractors and shutting down phony claims for wholesale drug prices." But Thomas' "push" to boost payments to Medicare+Choice health plans -- many of which announced last week that they will pull out of the program -- may hold up other reforms. Goldreich also notes that the Ways and Means health subcommittee will on Sept. 25 consider the Medicare Regulatory Relief Act, which would give providers accused of billing errors or fraud "stronger rights against payment cutoffs."
• Patients' rights: Goldreich predicts there will be no move to form a conference committee on patients' rights until January. Such a committee would be tasked with rectifying differences between separate patients' rights measures that passed the House and Senate over the summer. However, Goldreich also notes that in an effort to continue an atmosphere of bipartisanship, legislators could move on patients' rights before recessing for the holidays.
• The uninsured: With the country apparently headed for or already in recession, Goldreich says that economic problems will "only add to demand to expand Medicaid eligibility for the working poor." Goldreich predicts that "if Congress makes any news on health care this year it will be to use some of the $28 billion it set aside to help the uninsured."