Fire boat response crews battle the blazing remnants of the off shore oil rig Deepwater Horizon, April 21. Photo: U.S. Coast Guard

The largest oil spill in U.S. history has received no absence of congressional scrutiny. Yet as lawmakers continue to focus their examinations on the environmental, economic and energy implications of the disaster, a number of labor advocates are beginning to wonder: What about the workers?

Eleven men were killed, and dozens more injured, when the Deepwater Horizon oil rig exploded in April about 40 miles off the coast of Louisiana. The youngest victim, Shane Roshto of Franklin County, Mississippi, was 22; the oldest, Keith Blair Manuel of Eunice, Louisiana, was 56. None of the bodies was recovered.

Yet their stories have become mere footnotes beneath the other narratives that quickly monopolized the national headlines — particularly the environmental and economic threats posed by the millions of gallons of crude oil that have gushed into the Gulf of Mexico since the blast.

Worker advocates are quick to acknowledge the severity of the ongoing leak. Still, many also warn that ignoring the worker safety issues exposed by the tragedy would be a mistake, especially considering that hundreds of oil and gas rigs — among the most statistically dangerous workplaces in the country — remain active off the nation’s shores.

“The worker safety issue has been completely lost in this story,” said Tom O’Connor, executive director of the National Council for Occupational Safety and Health, an advocacy group. “It’s one of the biggest industrial disasters in recent history, and yet Congress [views it] the same as the public: They’re not seeing it as a worker safety issue.”

Federal statistics support O’Connor’s call for concern. Between 2003 and 2008, 646 oil and gas workers were killed on the job, according to the Bureau of Labor Statistics, including 120 in 2008 — more than twice the number killed in all other mining-related accidents. That year, the oil and gas industry accounted for more than 10 percent of all workplace fatalities resulting from fires and explosions. And offshore rigs are hardly immune. Between 2001 and 2009, 60 offshore workers were killed on the job, while more than 1,600 were injured, according to the Minerals Management Service.

The reaction to the Deepwater Horizon incident contrasts sharply with the response to another recent industrial disaster: the April 5 explosion at the Upper Big Branch coal mine in southern West Virginia that killed 29 workers and almost killed a 30th. In the wake of that tragedy, it was concern for the well-being of the miners that captivated lawmakers and spurred their indignation.

“[Miners] deserve nothing less than a safe working environment, and an employer who respects and values their safety,” Sen. Robert Byrd (D-W.Va.) said in April, echoing the sentiments of many colleagues. “We must reexamine the health and safety laws we have put into place and what more may need to be done to avoid future loss of life.”

Since then, three separate labor panels — the Senate HELP Committee, the Senate Appropriations Labor Subcommittee, and the House Education and Labor Committee — have examined the Upper Big Branch accident.

None of those panels has held hearings on the Deepwater Horizon explosion. Senate Democratic leaders were quick to call Gulf spill hearings in the energy, environment and homeland security committees. And in the House, both the energy and natural resources panels have examined the disaster, while the head of the government oversight committee has launched an investigation into the actions of federal regulators prior to the accident. But none of the scrutiny has focused on worker safety.

Part of the reason is likely jurisdictional. Unlike mine safety — which is monitored by a branch of the Labor Department (the Mine Safety and Health Administration) and therefore overseen by Congress’ labor panels — offshore drill rig safety is a responsibility split between the Minerals Management Service, a part of the Interior Department, and the Coast Guard. Neither agency falls under the watch of Congress’ labor experts. (A provision of a 1970 labor law has allowed both the MMS and the Coast Guard to preempt the oversight authority of the Labor Department’s Occupational Safety and Health Administration, OSHA, which focuses exclusively on workplace safety.)

Critics of that arrangement contend that the other responsibilities of the MMS and the Coast Guard dilute their concentration on occupational safety. Peg Seminario, safety and health director for the AFL-CIO, suggested that as a result of the 1970 law, the wrong agencies are in charge of overseeing offshore oil rigs. “Those most focused on worker safety and the environment — OSHA and the EPA — don’t have a say in this,” she said. “It’s an area that clearly needs attention.”

Calls seeking comment from the MMS and the Coast Guard were not returned.

The Obama administration has taken some steps to prevent similar disasters from occurring in the future. Last Thursday, the administration acknowledged that the safety rules for offshore rigs have been lacking, announcing strict new operating requirements for those projects, as well as a six-month moratorium on deep-water drilling. And faced with criticisms that the MMS’ duties — which include oil rig leasing, revenue collection and safety enforcement — are conflicting, the Interior Department recently split the agency into three separate parts, one of which will focus exclusively on the “oversight, safety, and environmental protection in all offshore energy activities.”

Meanwhile, congressional labor leaders are urging worker safeguards where they do have jurisdiction in the Gulf region: on land. Rep. George Miller (D-Calif.), chairman of the Education and Labor Committee, wrote to OSHA on Thursday seeking assurances that the agency is protecting workers involved in the cleanup efforts, some of whom have been hospitalized with headaches, nausea and vomiting.

“Much is still unknown about the long-term health effects of chemicals utilized in this cleanup,” Miller wrote.

“Especially given the health and safety track record of [BP], heightened vigilance is necessary to ensure that every person aiding the cleanup is provided the necessary information, training and equipment to protect themselves.”

Transocean Ltd., the Swiss company operating the doomed Deepwater Horizon oil rig when it blew up last month, raised plenty of eyebrows last week when it announced its plan to pay out $1 billion in dividends to shareholders.

“It’s heartwarming to see that Transocean, the same company that rushed to limit its liability in the Deepwater Horizon rig explosion, seemed not to hesitate at all when it came to the decision to distribute its profits,” one maritime expert wrote of the plan.

Today, 19 Senate Democrats — including Sen. Amy Klobuchar — took the scrutiny a long step further, asking the Justice Department to investigate whether those payouts are appropriate “at a time when [the company] may be responsible for financial damages related to the massive oil spill in the Gulf of Mexico.”

“Transocean’s stockholders,” the lawmakers wrote in a letter to Attorney General Eric Holder, ”should not take huge profits from polluting our country’s Gulf Coast.”

We are concerned that such action to quickly move money out of corporate coffers to individual investors may make it more difficult to pursue liability claims against the company.  Families of those who died in the disaster, the fishing industry that has been devastated by the oil spill and the governments that have worked full-time to clean up this spill deserve better.  Transocean has also reported that it expects to make a $270 million profit on its insurance policy for the Deepwater Horizon, since the rig was insured for more than it was worth.

Signing onto the letter were Democratic Sens. Pat Leahy (Vt.), Charles Schumer (N.Y.), Tom Harkin (Iowa), Robert Menendez (N.J.), Mark Begich (Alaska), Byron Dorgan (N.D.), Patty Murray (Wash.), Jeanne Shaheen (N.H.), Bill Nelson (Fla.), Mark Pryor (Ark.), Mark Udall (Colo.), Jeff Merkley (Ore.), Max Baucus (Mont.), Amy Klobuchar (Minn.), Michael Bennet (Colo.), Blanche Lincoln (Ark.) and Robert Casey (Pa.).

Of note, Transocean is not exactly known for its corporate citizenship. Until recently, the company was based in Houston, but officials moved the headquarters to Switzerland “to avoid paying higher corporate taxes.“

Rep. Joe Sestak (D-Pa.) won a Senate primary on Tuesday, while Bill Halter (D-Ark.) forced Sen. Blanche Lincoln into a runoff.

The results from Tuesday’s much-watched congressional primaries are in. Now the larger question remains: What’s their significance?

The fall of five-term Sen. Arlen Specter (D) in Pennsylvania marks the end of an era; the rise of ophthalmologist Rand Paul (R) in Kentucky lends both power and voice to the ever-emerging Tea Party movement; and the success of Arkansas Lt. Gov. Bill Halter — who hung close enough to Sen. Blanche Lincoln, a conservative Democrat, to force a run-off contest next month — has drawn cheers from the liberal groups that catalyzed his late ascendancy.

Yet the well-worn theme going into the day’s elections — that a nationwide storm of voter unrest spells mid-term doom for “big government” incumbents, particularly the majority Democrats — was hardly proven. Indeed, two of the three high-profile races featured establishment candidates taking on other establishment candidates — with the liberals coming out on top. If any common message emerged from Tuesday’s results it was this: Republicans, who have been hoping that the public’s discontent will translate into big congressional gains in November, might want to reconsider their strategy come Wednesday.

Specter, for example, was toppled by a more liberal Democrat in the figure of Rep. Joe Sestak, whose late campaign push revolved around ads linking Specter — a Republican from 1965 until he switched parties last year — to George W. Bush. Sestak will now square off against former GOP Rep. Pat Toomey, founder of the conservative Club for Growth, in November.

In Arkansas, Halter rode the wave of an enormous ad campaign bankrolled by some of the nation’s most predominant liberal groups, including MoveOn.org and a number of labor unions, who have been critical of Lincoln’s opposition to climate change legislation and an idling labor reform bill. And while Halter’s name isn’t well known on a national stage, the lieutenant governor is also no political outsider. As the Guardian’s Michael Tomasky wrote Tuesday, a Halter win “would not represent primary voters manifesting some bestial urge to tear the flesh of the establishment. He’s a member of the establishment.”

The run-off election between Halter and Lincoln is scheduled for June 8.

More evidence that the anti-establishment backlash remains unproven arrived Tuesday in western Pennsylvania, where Democrat Mark Critz, a former aide to the late Rep. Jack Murtha (D), defeated Republican Tim Burns in a special election. The result was a blow to Republicans, who’d viewed Murtha’s seat as low-hanging fruit in a conservative district amidst an unemployment crisis.

“If you can’t win a seat that is trending Republican in a year like this, then where is the wave?” former GOP Rep. Tom Davis (Va.) told The New York Times before the outcome of the race was known. “It would be a huge upset not to win this seat.”

Not that there hasn’t been good evidence of a conservative backlash against incumbents in some districts. Sen. Robert Bennett (Utah), for example, a faithful conservative, was unseated in a primary earlier this month by an opponent who attacked him for supporting Bush’s bailout of Wall Street. And Paul’s win in Kentucky came at the expense of Trey Grayson, Kentucky’s secretary of state who’d won the endorsement of no less an entrenched Republican than Senate Minority Leader Mitch McConnell (Ky.).

Yet Tuesday’s primary results indicate that there’s more at play than a simple backlash against establishment figures. Another wild card on display Tuesday was the extent of the Obama administration’s willingness to throw its weight behind longtime incumbents. Newsweek’s Howard Fineman noted that Specter, for example, was abandoned by the White House in the lead-up to his defeat Tuesday. Fineman pointed to a report by NBC’s Chuck Todd indicating that the administration, after endorsing Specter, actually preferred Sestak.

The fact that White House political spin doctors would say this to Chuck Todd in time for him to go on the air with it at 5 p.m. Eastern, on a popular political show hosted by Philly native [Chris] Matthews, with the polls open until 8 (!), enraged [Pennsylvania Democratic Rep. Robert] Brady. “I guess that’s the White House’s idea of loyalty,” he snapped. “They’re gonna hear from me.”

Meanwhile, House Majority Leader Steny Hoyer (D-Md.) predicted Tuesday that the creation of jobs — if it continues – will, come November, overcome the current attitude of voter discontent against Democratic incumbents who pushed through the party’s economic stimulus bill and an overhaul of the nation’s health care system.

“Americans are pretty smart people,” Hoyer told reporters at the Capitol Tuesday. “If they see this continued success, I think they’re going to say, ‘Well, I was doubtful, but it seems to be working, and we will stay the path.’”

Whether he’s right or not remains to be seen. But Tuesday’s results are no indication one way or the other.

Fire crews battle the blazing remnants of the oil rig Deepwater Horizon, April 21. Photo: U.S. Coast Guard

On the surface, the two accidents couldn’t have been more different. The first occurred in the rugged mountains of Appalachia; the second was more than a thousand miles away in the Gulf of Mexico. One was miles underground; the other thousands of feet underwater. One happened in pursuit of coal; the other in the unending search for domestic oil.

Yet last month’s deadly explosion at the Upper Big Branch coal mine in southern West Virginia, and the more recent fatal blast on the Deepwater Horizon oil rig off the coast of Louisiana, have at least this much in common: Both were likely preventable, according to a growing number of lawmakers and workplace safety experts — if only federal regulations designed to prevent such disasters had been enforced.

“I don’t believe it is enough to label this catastrophic failure as an unpredictable and unforeseeable occurrence,” Sen. Jeff Bingaman (D-N.M.), chairman of the Senate Energy and Natural Resources Committee, said during a Tuesday hearing on the Deepwater Horizon disaster. “If this is like other catastrophic failures of technological systems in modern history … we will likely discover that there was a cascade of failures: technical, human and regulatory.”

The message is clear: Regulations are only as good as the people enforcing them. And Congress, some experts are warning, would do well to recognize that trend as lawmakers contemplate reforms as diverse as those governing coal mines, oil rigs and Wall Street.

Along those lines, Paul Krugman, Nobel Prize–winning economist for the New York Times, noted this week that the problems at the Interior Department are by no means unique. Instead, they represent “a broader pattern that includes the failure of banking regulation and the transformation of the Federal Emergency Management Agency … into a cruel joke.” The common thread, Krugman argued, “is the degradation of effective government by antigovernment ideology.”

Krugman targeted the Bush administration in particular. But many work safety experts are quick to note that the lax enforcement over the extraction industries represents a much broader trend, beginning well before Bush took office, and extending well beyond his exit. Along the way, federal enforcement agencies have been stacked, at times, with anti-regulation regulators — many of whom still remain. And the industries have showered millions of dollars on Congress in order to persuade lawmakers that, when it comes to protecting workers, business knows best. The results have been predictable.

“We have a strong anti-regulatory bent in this country,” said Celeste Monforton, former work-safety official in the Labor Department who’s now at George Washington University, “Regulation is like a four-letter word.”

In the case of the Deepwater Horizon, which is leased by BP, the Interior Department is now under a microscope on several fronts. For one thing, the Minerals Management Service granted the rig a “categorical exclusion” from a federal law designed to protect the environment from significant spills. (The agency simply didn’t believe that such a spill was possible from that project.) And quite separately, the MMS has spent the last decade transferring most of its safety-enforcement duties to the industry, in effect allowing the drillers to police themselves. The trend has led lawmakers, in the wake of last month’s deadly accident, to accuse the agency of being too close to those it’s charged with regulating.

“Clearly, stronger, more independent oversight of oil company activities is needed,” Sen. Barbara Boxer (D-Calif.), who heads the Senate Environment Committee, said during a separate hearing on the spill Tuesday afternoon.

Acknowledging that problem, Interior Secretary Ken Salazar announced Tuesday that the agency plans to split the MMS into two separate entities: One would be charged with inspecting rigs and enforcing safety measures; the other would be responsible for managing leases and collecting royalties.

Similar regulatory questions have dogged the Mine Safety and Health Administration, particularly following the deep-mine blast in Raleigh County, W.Va., on April 5. In the days and months leading up to the explosion, federal investigators had cited the mine for a long list of safety violations. Ultimately, though, they didn’t take any steps to close the operation down. A number of mine-safety experts have charged thatMSHA leaders simply didn’t want to confront the powerful mining industry, even in the name of miner safety.

Ken Hechler, former West Virginia congressman and lead sponsor of a 1969 law that overhauled mining safety, said that his bill gives MSHA officials all the authority they needed to close down the troubled mine — if they had chosen to exercise it.

“The legislation is there on the books. You can tell in black and white precisely what it means,” Hechler said in a recent phone interview. “This is why I regard MSHA as partially responsible [for the tragedy].”

Most observers are quick to caution that the cause of neither the Gulf spill nor the West Virginia blast have yet been discovered — and might not be learned for months to come. Indeed, investigators in West Virginia haven’t been able to enter theUBB mine yet, due to the accumulation of toxic gases. And emergency workers around the Deepwater Horizon are still concentrating all of their efforts on stopping the gusher, which is still spewing crude oil into the Gulf at a rate of 5,000 barrels per day.

There’s also a strong sense that the companies themselves should bear most of the blame if it’s discovered that they simply ignored existing safety measures. Peter Galvin, a former MSHA official, noted that both BP and Massey Energy, which owns the UBB mine, have troubling safety records. “In both cases, we have a large and very wealthy parent corporation with a history of ignoring worker safety and health risks until it is too late,” he said in an email.

Still, when companies fail to protect their employees, then it falls on regulators to intervene. And if they’re not doing it, Hechler said, then Congress needs to step in to force them to.

“This process of writing good laws that are not enforced,” he said, “somehow has to be toughened to require the enforcement.”

Aung San Suu Kyi. Photo: Wikipedia

In a symbolic gesture, the U.S. Senate approved a resolution Friday afternoon calling for the immediate release of Aung San Suu Kyi, the Burmese pro-democacy activist and Nobel Laureate whose been under house arrest at the hands of Burma’s military leaders for most of the last two decades. The resolution also urges the leaders of Burma’s brutal regime to respect human rights and conduct upcoming elections fairly.

“The election rules that were recently announced by this regime leave no opportunity for legitimate political dialogue because they prevent key stakeholders from participating, making the upcoming elections a charade,” Sen. Judd Gregg (R-N.H.), who sponsored the resolution, said in a statement yesterday. “The U.S. expects the military regime to dramatically expand political participation and create an environment free from fear and intimidation before we will consider elections in Burma as anything but a farce.”

Trouble is, Burma’s leaders haven’t cared what the United States thinks of them for decades, and they have no reason to start now. Despite being cut off from most of the West, Than Shwe and his minions have done just fine for themselves by forging lucrative gem, oil and timber deals with China, Thailand and other Southeast Asian neighbors, who’ve shown zero inclination to jeopardize those trade relations over something as petty as human rights.

Meanwhile, Suu Kyi’s pro-democracy party announced this week that it has chosen to disband rather than participate in an election that would require the party to accept the nullification of the 1990 vote that should have swept it into power.

Rep. Jim McDermott (D-Wash.). Photo: WDCpix

Most state unemployment programs are flat broke, according to federal analysts, and the states themselves are largely to blame.

Thirty-four state unemployment insurance trust funds have run dry as a result of the recent recession, forcing those programs to take out nearly $40 billion in federal loans to weather the storm, the Government Accountability Office revealed this week.

The crisis is no accident, experts argue, but instead represents a failure on the part of many states to build up a funding cushion during the good years that could see them through the bad. Unemployment taxes levied on employers, many contend, have simply been too low to provide that insurance.

“Long-standing UI tax policies and practices in many states over three decades have eroded trust fund reserves,” Andrew Sherrill, the GAO’s workforce director, told House lawmakers on the Ways and Means Income Security subpanel Thursday.

Andrew Stettner, deputy director of the National Employment Law Project, an advocacy group, echoed that message. “States,” he told the committee, “entered this recession far less prepared than they had entered any of [the] recent recessions over the past 35 years.”

The insolvency trend could have far-reaching ramifications, experts warn, threatening the capacity of struggling states to help jobless workers through the next recession. The trend also raises broader questions about how the UI system is funded. Sherrill told lawmakers that the funding formula is ripe for an overhaul.

“The long-term decline of UI funding, culminating in widespread borrowing by state trust funds and the dire financial condition of the program, raises critical questions about the ability of the program to function as it has in the past,” Sherrill warned. “Now is the time … to consider changes to federal program policies that could better assure the long-term financial structure of UI trust funds.”

The trouble, many experts say, is this: State UI programs — which provide 26 weeks of financial help to laid off workers looking for new jobs — are funded with a tax on employers. Yet states are given broad discretion to set their own rates, and in recent decades, they’ve drastically scaled them back. Indeed, between 1978 and 2008, Sherrill said, the minimum state UI tax rate on employers fell from an average of 1.14 percent to an average of 0.37 percent, relative to taxable wages. By contrast, the federal UI tax is an across the board 6.2 percent on the first $7,000 of wages.

“This is the single most important reason why so many state trust funds are insolvent today,” Stettler argued.

There’s another key factor contributing to the problem: The eroding wage base. That is, while states must establish a taxable base income of at least $7,000 (the federal standard) — and while many states go much higher than that — only 17 states index that base to wage inflation. It only makes sense that those states that are taxing a higher proportion of wages tend to have money remaining in their UI coffers. Indeed, NELP estimates that the insolvent states have an average wage base of $9,500, while the figure for solvent states is $20,500.

Some lawmakers are already eyeing the problem. Rep. Jim McDermott (D-Wash.), for example, blasted the ill-prepared states Thursday, arguing that they “ignored one of the basic rules of any insurance program, which is to save money in good times to pay out more during hard times.”

Not that the states are solely responsible for ensuring the solvency of the state UI programs. The GAO noted several reforms that Congress could enact on a national scale. The $7,000 federal wage base, for example, established in 1983, isn’t indexed to wage inflation. Doing so would force a number of states to hike their own taxable wage bases, which in turn would yield larger UI pools during periods of economic growth.

McDermott, who chairs the income security subcommittee, hinted Thursday that Congress would play a role in the reform process. “The question that will increasingly confront Congress is whether we can help states suffering from huge deficits in their UI funds, while also encouraging them to take the steps necessary to ensure a strong and solvent unemployment insurance system in the future,” McDermott said. “I think the answer is yes.”

Not everyone on Capitol Hill agrees. Rep. John Linder (Ga.), the senior Republican on the Ways and Means subpanel, blasted the notion that hiking UI taxes is the answer to the current insolvency crisis. That idea, he said, “is just the latest example of Democrats’ desire to never let a serious crisis go to waste.”

“They will use state insolvency caused by the recession and their failed trillion-dollar stimulus law to argue for even higher federal and state unemployment taxes, forever.”

In a swift train of events, the Senate last night passed a short-term extension of emergency unemployment benefits, which the House approved a few hours later and President Obama signed into law shortly afterward. “In these tough economic times,” Obama said, ”it is more critical than ever to bring relief to Americans who are working every day to find a job, and families that are struggling to make ends meet.”

Millions of Americans who lost their jobs in this economic crisis depend on unemployment and health insurance benefits to get by as they look for work and get themselves back on their feet.  I’m grateful that the House and Senate moved forward on this temporary extension today.  But as I requested in my budget, I urge Congress to move quickly to extend these benefits through the end of this year.  I also urge Congress to move forward on legislation to help small businesses grow and hire and other measures to increase the pace of job growth. This is my top priority, and I will fight day and night until every American who wants a good job has one.

The temporary extension — which allows unemployed workers who’ve exhausted their state-based benefits to access emergency federal help through June 1 — is designed to buy lawmakers more time to negotiate the longer-term extension that Obama is urging.

The Washington Post today runs a timely reminder that the nation’s unemployment rate will likely rise even as hundreds of thousands of jobs start being created. The reason is simple: The Labor Department equation used to crunch the jobless rate doesn’t consider those folks who’ve been so discouraged by the job market that they’ve stopped looking for work altogether. As the economy recovers, though, those folks will re-enter the official jobless pool, hiking the unemployment rate even as businesses are hiring.

The Post provides more detail:

The number of people looking for jobs rose by more than 200,000 last month compared with February, according to the Economic Policy Institute — and that’s a good sign, economists say. It means that Americans are seeing more jobs being created and that they’re optimistic about their prospects.

But the supply of new jobs — 162,000 in March, the biggest monthly increase in three years — will accommodate only a fraction of the unemployed. Some economists say the jobless rate will not recede to pre-recession levels near 5 percent for four more years.

If anything, this is reminder that the official jobless rate is always misleading — and that lawmakers (not to mention journalists) would do better to recognize the broader numbers when tackling the topic.

The Department of Labor this morning released its much-anticipated employment numbers for March, indicating that the economy created 162,000 new jobs last month, but the nation’s unemployment rate remained 9.7 percent.

Some economists see the figures as the first clear sign that the economy is on the rebound. “Unlike previous months in which payroll gains were limited to the health and education sectors and to temporary help agencies, the latest report suggests that job gains are now more broadly distributed across the private economy,” Gary Burtless, formerly with the Labor Department and now at the Brookings Institution, said in a statement today. “In March there were small gains in manufacturing, construction, and many service-producing industries.”

Democrats, though, are being cautious not to overhype the figures. Certainly the creation of 162,000 jobs is an improvement on the 700,000-per-month job losses that were the trend a year ago. But there are signs in today’s report that a long road remains for the millions of Americans struggling to find work. Indeed, the number of long-term unemployed — those out of work for more than 27 weeks — jumped by 414,000 in March, to 6.5 million. That means that more than 44 percent of all jobless Americans have been out of work for more than half a year — a statistic that’s alarming to advocates for the unemployed.

“The long slog of looking for work and surviving on jobless benefits is going to continue for millions of Americans,” Christine Owens, executive director of the National Employment Law Project, said in a statement today. ”It’s Congress’ job now to take effective and aggressive steps to create jobs and extend unemployment through the end of the year, so that the economy can get back on its feet.”

The deadline to file for the next tier of unemployment benefits arrives next Monday, during a week when Congress is on recess. NELP estimates that the deadline will cause as many as 212,000 unemployed workers will lose their benefits in that week alone.

Yet a provision of the newly passed health reform bill that raises doctors’ payments under Medicaid is both temporary and limited in the scope of medical services it covers. The restrictions have left a number of health care advocates and doctors’ groups concerned about patients’ long-term access to care under the reform legislation.

The concerns are hardly trivial. The Democrats’ health reforms rely heavily on the successes of Medicaid, which will be expanded to include all non-seniors earning up to 133 percent of the federal poverty level (about $24,350 for a family of three). The bill is estimated to cover 32 million uninsured Americans over the next decade, and roughly half of those folks would fall into the Medicaid program.

Yet Medicaid rates are so low that many doctors refuse to see patients insured by the program. Indeed, doctors treating Medicaid patients in 2008 were paid just 72 percent of what Medicare paid for the same services, according to analysts at the Urban Institute, a Washington-based policy shop. As a result, only about 40 percent of physicians accept all new Medicaid patients, versus 58 percent for Medicare beneficiaries, according to a 2009 study from the Center for Studying Health System Change, which randomly surveyed more than 4,700 physicians.

Recognizing that problem, House Democrats passed legislation in December hiking certain payments under Medicaid to at least the level paid by Medicare, the federal program for seniors and the disabled. The bill initially passed by the House of Representatives allocated $57 billion to those rate increases over 10 years — a cost that Democrats more recently rejected as too high.

Instead, the health reconciliation bill signed by President Obama this week hikes Medicaid rates only for the years 2013 and 2014. The federal government would pay the entire tab of the increase, which the Congressional Budget Office estimates will cost $8.3 billion. From 2015 onward, it would fall to states to pick up the difference in cost — a tough sell in a frail economy, when state budgets are already strapped.

There are other concerns. The rate hikes, for example, apply only to some primary care and pediatric services. Emergency room and other critical care services wouldn’t be subject to the increase. Nor would counseling, disability examinations, services delivered over the phone or a long list of other procedures.

Dawn Horner, a health policy expert at Georgetown University’s Center for Children and Families, said the Democrats’ reform bill goes a long way to improve access to care for Medicaid patients, “but it would be better if the Medicaid increases were across the board.”

That’s not the only problem. Because the bill ties the Medicaid pay hikes to the senior-centered Medicare program, procedures not covered by Medicare won’t be included. That stipulation has led some children’s care providers to worry that youngsters on Medicaid won’t have access to services specific to their age group. The flushing of kids’ ears, for example — a procedure common in pediatricians’ offices — wouldn’t qualify for the enhanced rate.

Providing some comfort to health care advocates, CBO has projected that some federal funding will go toward the Medicaid pay hike for a few years after 2014 — indicating that some states would likely phase out the higher rates instead of dropping them immediately, even if they have to cover a percentage of the costs themselves. By 2019, however, CBO projects that, without additional federal help, all states will have abandoned the increased payments, putting Medicaid patients in the same uncertain spot they were in prior to the reforms.

The concerns among some powerful stakeholders in the health care arena — including governors, doctors and patient groups — mean that there will be plenty of pressure on Congress to prevent the Medicaid pay increases from evaporating in 2015.

“It will be a fight … to extend it,” William Vaughan, a health policy consultant for Consumers Union, a consumer advocacy group, wrote in an email. “And that’s a fight worth making!”

In the meantime, though, patient advocates and doctors’ groups are celebrating the increase they got.