Senate Christmas Shopping: List of Health Care Buyouts

Here’s the first round of the Republicans’ disclosures, compiled by the Republican Study Committee, of the Senate Democrats bribing each other to get votes on health care.

Over 10 states received special deals.

$$ Deals by Senator

Changes for Sen. Ben Nelson (Nebraska), aka the ‘Cornhusker Kickback’

1. The federal government will pay for all new Medicaid enrollees in Nebraska. CBO estimated cost: $100 million.  It looks small compared to the other deals negotiated, yet over the long-term will cost far more, since funding continues indefinitely.

2. Nebraska non-profit insurers get out of insurance tax, specifically the Mutual of Omaha Insurance Company and Blue Cross Blue Shield Plans (BCBS) of Nebraska (and Michigan). This means they will probably pay $15 million and $20 million less in fees.

3. An exemption from taxes for Medicare supplemental (“Medigap”) insurance providers.  Specifically, Mutual of Omaha, will not have to pay taxes on Medigap insurance, while reports also indicate that this tax break will be extended to other companies.

4. Some changes requested by Nelson would benefit people across the country, such as the inflation adjustment to the $2,500 cap on tax-exempt contributions to Flexible Savings Accounts (FSAs) and exemptions for nearly 55 physician-owned hospitals that have a provider agreement to participate in Medicare by August 1, 2010 (pushed back from February 1, 2010).

Changes for Sen. Levin (Michigan)

1. An exemption from the insurance tax for Michigan non-profit insurers, with language written in a way that applies to Blue Cross Blue Shield Plans (BCBS) of Michigan (and Nebraska).

2. Furthermore, the amendment changes the extension of section 508 hospital provisions so that hospitals in Michigan (as well as Connecticut) have the option to benefit under them if it means higher payments.

Changes for Sen. Sanders (Vermont):

1. Vermont gets a 6-year increase in funds from the federal government for Medicaid. Cost: an additional $600 million over ten years.

2. The amendment includes a provision pushed by Sanders to provide an additional $10 billion in funding for community health centers and the National Health Services Corps (which he argues would provide primary care to 25 million more people).

Changes for Sen. Landrieu (Louisiana), aka the ‘Louisiana Purchase’: $300 million increase in Medicaid funding for Louisiana.

Changes for Sen. Bill Nelson (Florida): Medicare Advantage cuts reach $120 billion, but Florida residents, as well as some individuals in Pennsylvania and New York, and potentially Oregon, will be grandfathered out of receiving cuts. When McCain tried to offer an amendment to allow all enrollees to be grandfathered in, 57 Democrats voted against it.

Changes for Hawaii:  The Manager’s Amendment singles out Hawaii as the only state to receive a Disproportionate Share Hospital (DSH) extension.

Changes for Sen. Lieberman (Connecticut): Hospitals in Connecticut get same deal Levin cut for Michigan.

Changes for Sen. Dodd (Connecticut): Connecticut gets $100 million for a “Health Care Facility” at a public research university that contains a state’s sole public academic medical and dental school — criteria designed to apply to the University of Connecticut.

Changes for Sen. Baucus (Montana): Baucus secured a pilot program that will help residents of Libby, Montana by allowing them to sign up for Medicare benefits.

Changes for Massachussetts: Massachusetts will receive a 3-year increase in federal funding for Medicaid. Cost: an additional $500 million over ten years.

Changes for Frontier States: Senators Dorgan and Conrad’s (both North Dakota) “protections for frontier states” provision would, starting in 2011, cut deals for hospitals and physicians in states where at least 50% of the counties in the state are “frontier.” Not surprisingly, states that qualify and benefit from the provision are Montana, South Dakota, North Dakota, Utah, and Wyoming.