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Baucus Health Care Bill Filled With State Specific Enticements

October 20, 2009 - by Paul Blumenthal

Bloomberg reports that the health care bill reported out of the Senate Finance Committee (S. 1796) contains numerous provisions aimed at specific states. These enticements could be used to secure wavering Democrats or allow senators in tough 2010 election races to tout to constituents. One prime beneficiary is Majority Leader Harry Reid:

Reid secured provisions to ensure his state of Nevada won’t face higher Medicaid costs.

Democrats want to expand coverage by loosening eligibility rules for the joint federal-state health-care program for the poor. Some governors say that could saddle them with higher bills. State spending would increase by $33 billon under Baucus’s plan, the Congressional Budget Office says.

The plan calls for “full federal funding” of Medicaid for new beneficiaries in only those states that had unemployment rates of at least 12 percent in August and whose Medicaid enrollment is below the national average.

Only Nevada, Rhode Island, Michigan and Oregon meet that criteria. That prompted complaints from other lawmakers that their states would have to pay more.

There are other equally obscure legislative provisions for other states:

Democrats such as Senators Bill Nelson of Florida and Ron Wyden of Oregon secured provisions setting aside $5 billion to shore up benefits for constituents who participate in Medicare Advantage. That program allows private insurers to contract with the government to provide Medicare benefits.

The bill that came out of Senator Max Baucus’s finance committee cuts more than $100 billion from Medicare Advantage to help fund the overhaul. Some lawmakers say they are concerned the elderly will see a reduction in benefits.

The measure doesn’t identify which states could get the $5 billion. The language is so confusing — those eligible include retirees in “counties where the MA benchmark amount in 2011 is equal to the legacy urban floor amount” — that even congressional aides said they aren’t sure.

Hopefully when the full bill language is up here on Open Congress, you users can dig in and find some more of these obscure state-specific enticements.

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