Capitol to Capitol
An Information Service of NCSL's Standing Committees

Volume 17   Issue 18 - May 7, 2010


This week congressional leaders repeated their intention to finish H.R. 4213, legislation that would give states six months of additional enhanced Medicaid match assistance, before the Memorial Day recess. Michigan Representative Sander Levin, chair of the House Ways and Means Committee, stated that H.R. 4213 would be on the House floor in two weeks. That would be cutting it very close, depending on the legislative vehicle, funding, contents and offsets. Discussions about the vehicle swirl around whether to complete a conference committee on H.R. 4213 or have the House amend the legislation and send it back to the Senate for another vote. Funding depends on the number and contents of provisions that are included in H.R. 4213. The Senate-passed version includes the Medicaid match extension, tax extenders, unemployment benefit extensions, COBRA premium subsidy extensions and blockage of a reduction in Medicare physician reimbursements. Various House members have suggested adding a Build America Bonds extension, “cash for caulkers” and other “jobs” pieces that might be left out. Some of these additions could balloon H.R. 4213 to $180 billion or more. This leads to the question of offsets and how much of the bill will be paid for—or how much of the legislation will be jettisoned, halved or otherwise reduced to accommodate the offset demand. Georgia Senator Don Balfour and Massachusetts Senator Dick Moore, NCSL’s President and President-elect, again urged in a May 7, 2010, letter that Congress to pass the six-month enhanced Medicaid match extension. Full text of the letter is available at . (NCSL staff contacts: Michael Bird, Jeff Hurley [“jobs” bills generally], Joy Johnson Wilson, Rachel Morgan [Medicaid])


The Senate continues to deliberate on S. 3217, legislation that would alter the manner in which financial institutions are regulated at both the federal and state level. This week, Senate lawmakers came to an agreement on resolution authority regarding so-called “too-big-to-fail” provisions within the legislation, which opens the door for the Senate to address a bevy of amendments that have been filed. One such amendment, introduced by Sen. Patrick Leahy (D-Vt.), would repeal the antitrust exemption for health insurance companies and thus repeal certain sections of the 1945 McCarran-Ferguson Act that gave states the sole authority to regulate the business of insurance. NCSL is monitoring both the reform bill and its amendments and will provide more information as the Senate moves to pass S. 3217 in the coming weeks. (NCSL staff contacts: Neal Osten, Jeff Hurley)


We start with a correction. NCSL’s first webinar on enacted legislation and state implementation issues will be held on Monday, May 17, 2010. The last issue of Capitol to Capitol offered May 9, 2010, as the webinar date. The topic of the first webinar remains the same: high-risk pools.

Be on the lookout for a comprehensive health care reform update in next week’s Capitol to Capitol. In the meantime, the latest activity on health reform can be viewed at (NCSL staff contacts: Joy Johnson Wilson, Rachel Morgan)


The Senate will likely spend all of next week and beyond on financial services reform legislation…The House has a much lighter schedule that features debate on science and technology programs…Very little progress and no final word on whether Congress attempts to move and finalize a FY 2011 budget resolution.

NCSL Legislative Summit. May 7 is the last day to take advantage of early bird savings on registration for the Legislative Summit in Louisville, Kentucky. Online registration is available at