Deal on Health Benefits for Trade-Displaced Workers Could Lead to Broader Uninsured Assistance, CQ’s Goldreich Says

The Senate this week is expected to take up legislation that would provide health coverage and other benefits to U.S. workers displaced by international trade, a debate that could ultimately have the broader impact of helping the nation's 40 million people without insurance, Congressional Quarterly's Samuel Goldreich reports in this week's "Congressional Quarterly Audio Report." As part of a measure providing presidential "fast-track" trade negotiating authority, the legislation would offer trade-displaced workers a 75% federal subsidy to purchase health insurance through COBRA, the 1986 Consolidated Omnibus Budget Reconciliation Act, which allows unemployed workers to keep their employer-sponsored health coverage by paying 102% of the premiums. Debate over the provision echoes last year's arguments over economic stimulus legislation, Goldreich reports, with Democrats backing the COBRA subsidy while Republicans suggest benefits should be provided through tax credits. But Goldreich says the benefit stands a better chance of passage this time -- President Bush has made fast-track trade authority "one of his top priorities," and Sen. Charles Grassley, the ranking Republican on the Senate Finance Committee, "said he expects to work a deal" on the health benefits with committee Chair Max Baucus (D-Mont.). Such an agreement could involve a combination of COBRA subsidies and tax credits. Grassley said that "if lawmakers want it to," the trade bill could "provide sort of a template" to help the nation's uninsured on a broader scale.

A 'Breakthrough' on Medicare Rx?
On the Medicare reform front, last week saw "something of a breakthrough" when HHS Secretary Tommy Thompson and White House health policy adviser Mark McClellan separately told congressional committees that the administration might accept a $350 billion, 10-year plan to overhaul the program and add a drug benefit, rather than the $190 billion proposed in Bush's FY 2003 budget. Lawmakers in both chambers have "shown strong support" for the larger figure. The statements mean that "for once ... the administration is sending consistent signals on what it would accept from lawmakers on a Medicare drug benefit at a time when Congress is a serious about actually structuring the benefit and sending something along to the Senate from the House committee," Goldreich says. He notes, however, that the two parties remain divided on the structure of such a benefit, with Republicans supporting expanded use of managed care plans and Democrats backing drug coverage as a standard benefit under fee-for-service Medicare. And divisions exist even within the parties: Though House Ways and Means Chair Rep. Bill Thomas (R-Calif.) and Energy and Commerce Chair Rep. Billy Tauzin (R-La.) are "making a big show of putting together a joint bill they can quickly pass to the House floor," Tauzin backs Bush's plan to shift to the states short-term responsibility for helping low-income seniors buy drugs while Thomas supports "one uniform national benefit program." The divisions show "how hard it will be to strike a deal when Democrats and Republicans really start talking in the Senate," Goldreich concludes. Goldreich's full report, which also examines factors delaying passage of a bill to allocate $3 billion in bioterrorism spending, is available online (Goldreich, "Congressional Quarterly Audio Report," 4/22).