New York, 9-21-2001 - FEMA's Urban Search and Rescue teams amongst the wreckage of the World Trade Center. (photo: Andrea Booher/ FEMA via smiteme)

So, after both sides dug in, the pressure was apparently too much to hold back the 9-11 health care first responders bill, which will sail through the Congress today, the last day of the lame duck session. Joe Biden is in the chair right now to move along the bill. It is passing the Senate by unanimous consent.

But what’s in the deal? This is from Tom Coburn’s office:

· Reduction in Costs. This agreement saves taxpayers $6.2 billion from the substitute amendment and $7.5 billion from the House-passed bill. In the deal, costs are reduced to $4.2 billion in the 10-year window and eliminated outside the 10-year window. Of that amount, $1.5 billion will go to health benefits, while $2.7 billion will go to compensation.

· Permanently Close the Victims Compensation Fund (VCF) after 5 years. The original bill kept the VCF open through 2031, making it extremely susceptible to waste, fraud and abuse and incurring significant long-term costs. The fund is now open only through 2016 and has language to expressly say that it is permanently closed at after 5 years.

· Limitations on Attorneys Fees. Places a hard cap for attorneys’ fees at 10 percent of the total award and allows the Special Master to reduce attorneys fees he believes are excessive

· Prevents Reinstatement of Civil Claims. Prevent claimants who are rejected from the VCF from then pursuing a civil lawsuit. This is consistent with the earlier VCF policy.

· Limitation on Infrastructure Costs. Explicitly excludes construction and capital projects from health care spending in the bill.

· Commitment to ensure eligible individuals cannot “double-dip” on benefits. The Senators all agreed to get in writing from the Special Master that he will include workers compensation benefits in collateral sources of benefits that he must offset from potential compensation awards.

· More Accountability. Require claims-level data reporting to provide accountability and opportunity for oversight, as well as GAO reports to determine less expensive mechanisms to provide nationwide care, pharmaceutical access, and health information technology promotion.

Some of this is just face-saving, but the cost of the bill has significantly come down, from $7.5 billion to $4.2 billion. Kirsten Gillibrand and Chuck Schumer, New York’s two Senators, praised the deal as “workable” and the result of good-faith bargaining, but there is a cost here, and hopefully it won’t cause an unnecessary burden for the first responders.

Incidentally, the bill is entirely offset, so lowering the cost just reduces the offsets, which the Chamber of Commerce didn’t like because they removed corporate tax loopholes. So let’s not pretend that “we’re being frugal with the people’s money” here; we’re just letting corporate tax evaders off the hook. [cont’d.]

That said, I’m pleased this got done, capping off a very productive lame duck session. Savor it, because it’ll be the last positive movement for a while, in all likelihood. But it’s important to recognize the value of good communication and pressure, which can even move Republicans. Concessions eventually have to be made, of course, but the preferred course of action for the likes of Coburn was to not do this bill at all. The pressure made that impossible.

The other thing I’d say is that the deal had to be cut mainly because of the time it would have taken to pass the bill with three separate cloture votes. In a more functional Senate where a majority of the body approves of a measure and can get it through without needless delay, you wouldn’t need to make such deals.

David Dayen

David Dayen