Two Senate Committees Approve Portions of Economic Stimulus Package With Funds for Health Care

The Senate Appropriations Committee on Tuesday approved the $365 billion portion of an $825 billion economic stimulus package over which the committee has jurisdiction that includes funds for health care, CongressDaily reports (Sanchez, CongressDaily, 1/27).

Prior to passage, the committee made a few revisions to the $5 billion health information technology portion of the stimulus package. The committee approved an amendment proposed by Senate Special Committee on Aging Chair Herb Kohl (D-Wis.) that would expand the definition of health care provider to include nursing homes and other long-term care facilities. In addition, the committee added a provision to the stimulus package under which hospitals that have adopted health care IT could receive loans to help them meet federal privacy and compatibility standards (Noyes, CongressDaily, 1/28). The portion of the stimulus package approved by the committee includes almost the same privacy standards for electronic health records as the House version of the package (Wayne, CQ Today, 1/27). The committee also approved an amendment proposed by Sen. Tom Harkin (D-Iowa) to clarify that pharmacies or other entities can contact or market to consumers who have used certain products without violating privacy standards (Noyes, CongressDaily, 1/28).

In addition, the committee amended a provision that would provide $1.1 billion in funds for research on the comparative effectiveness of medical treatments to include the word "clinical" before every reference to such research, a move that could limit use of the results in treatment or coverage decisions by private health insurers and public programs (Edney, CongressDaily, 1/28).

The portion of the stimulus package approved by the committee also included:

• $3.7 billion for construction of new Department of Veterans Affairs hospitals and improvements to current facilities;
  
  
• $819.5 million for construction of new Department of Defense medical centers and wounded soldiers and military families (Johnson, CQ Today, 1/27);
  
  
• $5.8 billion for preventive health care, such as immunizations and screenings;
  
  
• $1 billion for construction and improvements to community health centers;
  
  
• $3.5 billion for NIH, with at least $1.35 billion allocated for biomedical research; and
  
  
• $412 million for construction of new buildings and equipment for CDC.

Senate Finance Committee Passes Portion of Stimulus Package
The Senate Finance Committee on Tuesday also approved a portion of the economic stimulus package over which the committee has jurisdiction that includes $18 billion for health care IT and funding to provide federal subsidies for health insurance under COBRA. In addition, the portion of the stimulus package approved by the committee includes $87 billion in additional federal Medicaid funds for states.

Prior to passage, the committee approved an amendment proposed by Sen. Jeff Bingaman (D-N.M.) under which states would receive 80% of the Medicaid funds as a flat rate increase and 20% based on their economic circumstances. The committee also approved an amendment proposed by Bingaman that would provide small states with additional funds under a Medicare program for hospitals that serve many low-income patients, as well as an amendment proposed by Sen. Jay Rockefeller (D-W.Va.) under which states would receive about $3.75 billion from Medicare for health care costs improperly covered by Medicaid (Wayne, CQ Today, 1/27).

Obama Meets With Republicans on Stimulus Package
President Obama on Tuesday traveled to Capitol Hill to meet with congressional Republicans to discuss the economic stimulus package, but "there was scant evidence he had persuaded many of them to back the measure," Reuters/Washington Post reports (Ferraro/Bohan, Reuters/Washington Post, 1/27). According to McClatchy/Miami Herald, the House likely will pass a version of the economic stimulus package on Wednesday, but Obama likely will "fall short of getting the strong bipartisan consensus he wants" (Lightman, McClatchy/Miami Herald, 1/28). The Senate "shows signs of greater bipartisanship" than the House, the AP/Long Island Newsday reports (AP/Long Island Newsday, 1/28).

Some Obama Supporters Raise Concerns About Stimulus Package
The Post on Wednesday examined how some supporters of Obama and Democrats have raised concerns that the economic stimulus package might "fall short in its broader goal" of "laying the groundwork for overhauls" of health care and other areas. For example, as part of an effort to "address Obama's longer-term goals" for health care reform, the stimulus package includes $20 billion of a total of $50 billion in funds that he seeks to invest in health care IT, which he has said would reduce costs, according to the Post. However, health care experts "worry that the pressure to spend it fast for stimulus reasons could keep the new network from being implemented as effectively as it needs to be to reduce costs," the Post reports (MacGillis, Washington Post, 1/28).

Privacy Standards Debated at Senate Hearing
In related news, the Senate Judiciary Committee on Tuesday heard testimony on the debate over privacy standards for EHRs included in the economic stimulus package, CQ HealthBeat reports. A number of health care experts said that strong privacy standards could limit the ability of providers to exchange information and endanger the lives of patients as a result. However, others said that strong privacy standards are needed to obtain the trust of patients. According to CQ HealthBeat, the "general tone of the testimony was that the safeguards will do for now and can be improved later through new legislation or regulation" (Reichard, CQ HealthBeat, 1/27).

Meanwhile, Sen. Olympia Snowe (R-Maine) on Tuesday raised concerns about a provision in the stimulus package that would exempt unintentional disclosures of medical information from the privacy standards and an "excessively broad" exemption for disclosures related to research (Noyes, CongressDaily, 1/27).

Stimulus Package To Help Hospices, Recently Unemployed Workers
Two newspapers recently published articles that examined how the economic stimulus package would help hospices and recently unemployed workers. Summaries appear below.

• Hospices: The House version of the economic stimulus package includes a $134 million provision that would reverse a reduction in Medicare reimbursements for hospice services, the AP/Augusta Chronicle reports. According to the AP/Chronicle, the provision would save the hospice industry more than $2 billion in the next five years and create 8,700 jobs in the next year (Hirschfeld Davis, AP/Augusta Chronicle, 1/27).
  
  
• Unemployed workers: Democrats have used the stimulus package as a "tool for rewriting the social contract with the poor, the uninsured and the unemployed, in ways they have long yearned to do" through provisions that would extend Medicaid eligibility to recently unemployed workers and provide federal subsidies for 65% of their health insurance premiums under COBRA, the New York Times reports. According to the Times, the stimulus package would provide $127 billion for health insurance over the next two-and-one-half years, "a fact that has Republicans fuming that the stimulus package is a back door to universal health coverage" (Pear, New York Times, 1/28).

Broadcast Coverage

• American Public Media's "Marketplace Morning Report" on Wednesday discussed the House version of the economic stimulus package (Henn, "Marketplace Morning Report," American Public Media, 1/28).
  
  
• NPR's "Day to Day" on Tuesday examined the provisions included in the stimulus package (Brand/Seabrook, "Day to Day," NPR, 1/27).
  
  
• NPR's "Morning Edition" on Wednesday reported on the health IT provisions included in the stimulus package and the challenges to increased adoption. The segment includes comments from John Halamka, chief information officer at Harvard Medical School; Paul Tang, chief medical information officer at the Palo Alto Medical Foundation; and James Gelfand of the U.S. Chamber of Commerce (Silberner, "Morning Edition," NPR, 1/28). "Morning Edition" on Wednesday also featured a segment on the meeting between Obama and congressional Republicans (Gonyea, "Morning Edition," NPR, 1/28).