Alan Weil, executive director of the National Academy for State Health Policy, said that although no one knows whether the Medicaid funding is sufficient, “states are going to need these dollars to retain the coverage that they have and deal with the expected increase in enrollment due to the economic downturn. Without it, we would have expected really substantial cuts in coverage.”
Another provision gives states $25 billion to help laid-off workers maintain their employee health benefits under the Consolidated Omnibus Budget Reconciliation Act (COBRA). Workers who lost their jobs between Sept. 1, 2008, and Dec. 31, 2009, will have 65% of their COBRA premiums paid for by the federal government for 9 months. The provision limits the subsidy to those workers with an individual income of up to $125,000 or a family income of up to $250,000, Ms. Stoll said.
“This will help a lot of folks become able to afford COBRA,” she added, noting that a recent report by her organization found that COBRA premiums eat up an average of 84% of a laid-off worker's unemployment benefits.
The law includes about $10 billion in funding for the National Institutes of Health to be used for research grants, construction, and the purchase of research equipment. The increased funding was praised by the American Heart Association for advancing the search for cures for heart disease, stroke, and other cardiovascular diseases.
“This is an important down payment on President Obama's pledge to double science funding over the next decade,” Nancy Brown, chief executive officer of the American Heart Association, said in a statement.
The significant boost in NIH funding also was praised by the nonprofit organization Research!America. “This step is a dramatic reversal of the discouraging funding our federal health research agencies saw in the past 6 years and will do much to make up for spending power lost during that time,” former Rep. John Edward Porter (R-Ill.), chair of Research!America, said in a statement. “In recent years, the NIH has been able to fund just 1 in 10 research projects deemed worthy of funding.”
A little over $1 billion has been directed toward comparative effectiveness research, with $300 million going to the Agency for Healthcare Research and Quality, $400 million to the NIH, and $400 million to be used at the HHS secretary's discretion.
The research will be overseen by a new national council that will advise Congress and federal agencies on priorities. Many in the pharmaceutical and medical device industry supported the notion of comparative effectiveness studies, but worked hard to ensure that the money would not be used to support coverage decisions. The House and Senate conference report specifically stated that the research could not be used to “mandate coverage, reimbursement, or other policies for any public or private payer.”
That brought applause from AdvaMed, the medical device industry trade group. “The purpose of the research is to assist patients and health professionals in making better treatment decisions, not to mandate one-size-fits-all coverage decisions that would deny patients access to safe and effective treatments,” Stephen J. Ubl, president and CEO of AdvaMed, said in a statement.
Primary care also got a boost in the bill, with $2 billion going to new and existing community health centers, and $500 million to training for primary providers including doctors, dentists, and nurses. Some of that $500 million will help cover medical school expenses for students who agree to practice in underserved communities through the National Health Service Corps.
Alicia Ault and Joyce Frieden contributed to this story.