The fact that the budget deal that will probably pass the House later today doesn't include an extension of emergency unemployment insurance benefits doesn't mean that those benefits will never be restored, but it does effectively guarantee they will lapse at the end of the year because after the House approves the budget, it's going to leave town until January.
Getting Republicans to agree to extend emergency UI didn't always require leverage, but these days it does, and that means that without coupling the extension with another must-pass piece of legislation, UI faces grim prospects. Democrats have been counting on the need to pass the so-called "doc fix" (legislation preventing cuts to payments to Medicare doctors) as a vehicle for extending UI, but yesterday House Republicans added a partial "doc fix" to the budget package.
Under the legislation, the "doc fix" will last for three months, through March of 2014, so it doesn't completely remove it as a vehicle for unemployment insurance, but it does reduce the urgency for Republicans to move swiftly, because while Medicare doctors won't face any lapse in payments, the long-term unemployed will. It's always possible that Congress could move quickly in January despite the fact that Republicans have given themselves a "doc fix" cushion, but it's going to take a concerted effort from House and Senate Democrats as well as the Obama Administration to push action. (Meteor Blades had a good post on Wednesday about one approach for doing this.)
Given that we're already seeing how Medicare doctors and their patients are getting taken care of while the long-term unemployed are getting screwed, it's worth noting that how the "doc fix" will be paid for:
A proposed short-term "doc fix," meanwhile, would prevent a 20-percent pay cut to physicians by extending cuts to set to hit hospitals that serve primarily uninsured patients.
The reductions to so-called disproportionate share hospitals are currently scheduled to begin next year and last through 2022. Under the "doc fix" proposal, the cuts would begin in 2016 but last through 2023, raising about $4 billion.
So it's not just the unemployed who are getting screwed, it's also both the insured and uninsured people who go to the hospitals facing the cuts, some of which will close as a result. But if there's a silver lining, it's that the cuts won't actually go into effect until FY2016 instead of FY2015, so just like Congress could in theory undo the damage of cutting off emergency unemployment benefits, it could also undo the damage of screwing hospitals that serve the poor. Good news, eh?