On Wednesday, the House Appropriations Committee on a 35-22 party-line vote approved a $358 billion portion of an $825 billion economic stimulus package that falls under the jurisdiction of the panel and includes funds for health care information technology investments and community health centers, the AP/Philadelphia Inquirer reports (Taylor, AP/Philadelphia Inquirer, 1/22).

The House Ways and Means Committee and the House Energy and Commerce Committee plan to hold mark ups on the portions of the stimulus package that fall under their jurisdiction on Thursday. Both committees likely will consider the portion of the stimulus package that includes $20 billion for health care IT, although some of the language for that portion of the legislation falls under the jurisdiction of the Energy and Commerce Committee alone, according to a Ways and Means Committee spokesperson. In addition, both committees will consider the portion of the bill that would expand access to COBRA and provide federal subsidies for the program. The Energy and Commerce Committee also will consider the portion of the bill that includes almost $96 billion for Medicaid, including $87 billion in additional reimbursements to state governments. The remainder would provide funds to allow states to expand Medicaid coverage low-income residents who lose their jobs through 2010.

Republican Concerns
On Wednesday, House Republicans, led by Minority Leader John Boehner (R-Ohio), sent a letter to House Speaker Nancy Pelosi (D-Calif.) to recommend that the stimulus package require states to submit budgets to Congress before they receive any additional Medicaid funds. "Unfortunately, the $87 billion allocated for more Medicaid money for states doesn't appear to hold them accountable for ensuring that the tax dollars are spent wisely," according to the letter. A Republican aide to the Energy and Commerce Committee said that House Republicans have raised concerns about who would qualify for federal subsidies for COBRA under the stimulus package (Wayne/Armstrong, CQ Today, 1/21).

Concerns Over Comparative-Effectiveness Research Language
Draft report language recently released by House Appropriations Committee Chair David Obey (D-Wis.) on a portion of the stimulus package that includes $1 billion for research on the comparative effectiveness of medical treatments has "set off a firestorm" because of concerns that the legislation would limit access to more expensive treatments, CongressDaily reports. The language states, "By knowing what works best and presenting this information more broadly to patients and health care professionals, those items, procedures, and interventions that are most effective to prevent, control, and treat health conditions will be utilized, while those that are found to be less effective and, in some cases, more expensive, will no longer be prescribed."

A House Democratic aide said that the language "was carefully crafted with all relevant committees in both chambers to be neutral on cost and coverage issues," adding, "Many people who are committed to advancing (comparative-effectiveness research) would like to see" the language "changed to better reflect the intent of the actual legislative language before this process is over." Senate Finance Committee Chair Max Baucus (D-Mont.) will work with House members to include "good" language on comparative-effectiveness research in the final version of the stimulus package, according to an aide (Edney, CongressDaily, 1/22).

Concerns Over Health Care IT
Meanwhile, a number of health care experts have raised concerns that the $20 billion included in the stimulus package for health care IT could "lead to wasteful spending" without changes to the current system, the Wall Street Journal reports. According to the Journal, the stimulus package "attempts to address many of the pitfalls associated with the rollout" through increased privacy protections, funds for regional networks, training for technicians and financial incentives for physicians to adopt electronic health records.

John Glaser, chief information officer for Partners HealthCare, said, "In some ways I am thrilled, because IT will need federal help. ... But you can bring in too much money too fast and not only waste it, but set us back." Glaser added, "If it's too hasty, you can create so many bad experiences that people say, 'My data's a mess and my patients are angry'" (Goldstein/Zhang, Wall Street Journal, 1/22).

On Wednesday, the National Association of Chain Drug Stores sent a letter to House Ways and Means Committee Chair Charles Rangel (D-N.Y.) that raised concerns about the health care IT privacy protections included in the stimulus package. NACDS recommended that lawmakers allow HHS to negotiate privacy protections with health care providers (CQ Today, 1/21).

Broadcast Coverage
American Public Media's "Marketplace Morning Report" on Thursday reported on opposition from House Republicans to portions of the stimulus package (Dimsdale, "Marketplace Morning Report," American Public Media, 1/22).