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Lawmakers Make Stimulus Deal

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Congressional leaders have resolved conflicts between the House and Senate versions of legislation that could subsidize health benefits for laid-off workers.

“The bills were really quite similar, and I’m please to announce that we’ve been able to bridge those differences,” Senate Majority Leader Harry Reid, D-Nev., said today.

A final, detailed description of the agreement was not yet available at press time, but a draft that was available included substantial funding for subsidizing Consolidated Omnibus Budget Reconciliation Act, or COBRA, group health coverage continuation benefits for laid-off workers.

The COBRA subsidy provision is a major component of a scaled-down, $789 billion version of H.R. 1, the American Recovery and Reinvestment Act. Congressional leaders hope to approve the stimulus package and send it to President Obama for his signature as early as Friday.

The final version appears to provide $21.4 billion in COBRA health benefits subsidies, down from $29 billion in the bill passed by the House in late January.

A Treasury Department mechanism would pay 60% of eligible workers’ COBRA premiums for 9 months. Individual filers with annual incomes over $125,000 and married filers with annual incomes over $250,000 would not be eligible for the subsidies.

The House version of the bill would have provided a 65% subsidy, and the Senate version would have provided a 50% subsidy. Neither version would have imposed an income limit on participants.

Employers and plan administrators could collect the subsidy by taking a credit against payroll taxes.

The conference report version of the bill also appears to provide $19 billion to fund a shift to electronic health records, with $17 billion for Medicare and Medicaid incentives and $2 billion for grants to the private sector. The health information technology allocation is down from $20 billion in the House version.

Starting in 2014, the conference report version would phase in payment penalties for Medicare physicians and hospitals not using electronic health records.

Bill authors are projecting a 90% electronic health record adoption rate for physicians and a 70% adoption rate for hospitals.

It was unclear at press time whether the final bill includes funding for research on comparative effectiveness of medical treatments.

The conference report version appears to include a provision that would create an Office of the National Coordinator for Health Information Technology and a provision that would require that a patient be notified of any unauthorized disclosure or use of health information.