An extension of enhanced Medicaid payments for states has been dropped from a bill that extended jobless benefits.

Opposition from fiscal conservatives in the House scuttled the payments over concerns that they would increase the federal deficit.

Also excluded was assistance in paying COBRA benefits for laid-off workers.

Surviving was a 19 month delay in a looming reduction in Medicare payments to physicians, as well as an assortment of tax cuts intended to spur research and development.

Approximately 20 states have written budgets in anticipation of receiving the extra Medicaid funds. Those states will now have to make cuts or find the revenue elsewhere.