<nobr>Feb 13, 2009</nobr>

House Approves Conference Report on Stimulus Bill; Senate to Take Up This Evening

Legislative Text and Conference Report Language Now Available

The House this afternoon approved on a partisan vote H.R. 1, the American Recovery and Reinvestment Act of 2009. The Senate plans to vote on the final bill this evening and, barring the loss of key votes in the Senate, the bill will be cleared for President Barack Obama's signature on Monday. The legislative text and conference report are available below.

The $789 billion economic recovery plan includes various tax incentives for individuals and businesses, authorizes increased spending on health care, education, transportation, and unemployment benefits, and additional Medicaid funding to the states. The legislation also includes a premium subsidy for certain eligible individuals for COBRA continuation health coverage, funding for the development of health information technology, and funding for health comparative effectiveness research.

Premium Subsidies for COBRA Continuation Coverage:

• Provides 65% subsidy for COBRA continuation premiums for up to 9 months for involuntarily terminated workers and their families.


• Eligible individuals are those involuntarily terminated between September 1, 2008, and December 31, 2009.


• Subsidy would terminate upon offer of any new employer-sponsored health care coverage or Medicare eligibility.


• Workers involuntarily terminated between September 1, 2008, and enactment, but failed to initially elect COBRA will be given additional 60 days to elect COBRA and receive subsidy.


• Participants same year income cannot exceed $125,000 for individuals and $250,000 for families.


• Dropped: House proposal to provide continuation coverage to Medicare eligibility to laid off workers 55 years of age and older and workers with 10 years of service with a company (55/10 provision).

Health Information Technology Provisions:

• Approves $19 Billion in incentives for providers and hospitals to adopt electronic health records.


• Defines breach as an intentional, unauthorized acquisition/access or disclosure of protected health information (PHI), and requires any individual whose PHI has been subject to a breach to be notified within 60 days of discovery of the breach.


• Extends privacy requirements to "business associates," and subjects them to civil and criminal penalties.


• Individuals can audit covered entities/business associates and require them to provide an account of PHI disclosures or transmissions.


• Forbids a wide range of marketing of services by covered entities or business associates based on PHI.


• State Attorneys General can sue in federal court entities accused of having violated provisions of this bill.

Comparative Effectiveness Research:

• $1.1 billion to the Agency for Healthcare Research and Quality, NIH and the HHS Office of the Secretary to evaluate the relative effectiveness of different health care services and treatment options.


• $1 billion for prevention and wellness programs to fight preventable diseases and conditions with evidence-based strategies.

The links below will take you to the various provisions of the bill. The health-information technology and comparative health research provisions are located in Division A, the COBRA health provisions are contained in Division B, and the tax provisions are in Division B. For the layperson's description of the various provisions, see the Joint Explanations.

Note that these documents are extremely large (the bill language is over 400 pages each) and may take some time to open upwards of 15 to 20 minutes depending on the speed of your computer. Also available are summaries of the various provisions by the Appropriations, Ways and Means, and Senate Finance committees.

Appropriations Committee Summary

Ways and Means / Senate Finance Committee Summary
Websites:

Division A: Appropriations Title

Division A Joint Explanation

Division B: Tax, Unemployment, Health, State Fiscal Relief, and Other Provisions

Division B Joint Explanation

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