Little Progress Likely on Uninsured Before Year’s End, CQ’s Goldreich Says

Senate Majority Leader Tom Daschle's (D-S.D.) statement that there is a 50-50 chance of a compromise on the economic stimulus package is "optimistic," Congressional Quarterly senior reporter Samuel Goldreich says in this week's "Congressional Quarterly Audio Report." Republicans, backed by President Bush, are offering a 50% federal subsidy of health insurance as a tax credit for individuals. On the other side, Democrats still advocate a 75% direct federal subsidy of coverage under COBRA (Goldreich, "Congressional Quarterly Audio Report," 12/17). COBRA, the 1986 Consolidated Omnibus Budget Reconciliation Act, allows unemployed workers to retain health coverage under their former employers' insurance plans by paying 102% of the premiums (Kaiser Daily Health Policy Report, 11/15). Both sides have agreed to spend about $12 billion or more on the issue, but Democrats have "insisted" on another $6 billion in federal aid to Medicaid programs in part to subsidize COBRA plans. Goldreich predicts that the stimulus debate will end Dec. 18 "with the House taking a face-saving vote" on a new GOP economic stimulus bill. Goldreich adds, "This will be like a teen movie sequel, giving GOP lawmakers a chance to go home for Christmas saying they voted on a new deal with more help for the unemployed and less tax breaks for big business but were blocked by Democrats in the Senate." This entire debate "essentially repeats a battle between Democrats and Republicans last spring over how to spend $28 billion to help the uninsured," Goldreich says. Although Congress might approve "something small and aimed at helping people affected by Sept. 11," there will not be progress on the "broader issue of the uninsured" before the end of the year, he adds. (See story 1 for more on the economic stimulus debate.)

Finishing Up
As for other issues in Congress, lawmakers have not "entirely" completed action on funding anti-bioterrorism efforts, even though the House has approved a $3 billion measure, Goldreich says. Holding up progress on the bill, the House and Senate have not reached agreement on language that would loosen antitrust rules and give drug makers liability protections to encourage research into new treatments for biochemical contamination. Further, lobbyists and employers are expected to convince Congress to drop efforts to approve a bill expanding the 1996 Mental Health Parity Act ("Congressional Quarterly Audio Report," 12/17). The original act prohibited private insurers from establishing annual and lifetime limits on mental health benefits, unless those same limits applied to other medical illnesses. The new measure would require health plans offering mental health coverage to provide full parity with physical health coverage, with respect to both costs (such as deductibles) and access to services (Kaiser Daily Health Policy Report, 10/31). Congress might come back to work for a week after Dec. 25 because action on final spending bills has not been completed, Goldreich says ("Congressional Quarterly Audio Report," 12/17). Goldreich's full report is available online.