SCHIP, Appropriations Bills Remain Top Issues On Congress' Agenda As Lawmakers Return From Thanksgiving Recess

Main Category: Medicare / Medicaid / SCHIP
Article Date: 04 Dec 2007 - 6:00 PDT

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Congress returns this week with "many of the year's most contentious issues waiting to be resolved" by the end of 2007, most of which have been the "subject of vetoes or warnings from the White House," USA Today reports (Kelley, USA Today, 12/3).

Senate Democrats are "crossing their fingers that the bipartisan desire to leave town for the holidays will help them unlock some of the remaining stalemates and allow them to get their work done in time," according to Roll Call. However, the "risk of having to punt much of their agenda into next year remains very real for Democrats," Roll Call reports (Pierce, Roll Call, 12/3). According to the AP/Minneapolis Star Tribune, "leverage is flowing to Bush, who's armed with both a veto pen and enough Republican allies in the Senate to sustain filibusters against bills they don't like" (Taylor, AP/Minneapolis Star Tribune, 12/3).

Omnibus Spending Measure Key Priority
The "most important piece" of legislation that needs to "fall into place" is an omnibus spending bill that would combine 11 annual appropriations measures, according to Roll Call (Roll Call, 12/3). Congress last month failed to override a presidential veto of a $606 billion fiscal year 2008 Labor-HHS-Education (HR 3043) appropriations bill. President Bush then rejected a proposal from Democrats that would have reduced the amount of spending sought for the FY 2008 budget. The Democratic proposal would have combined the 11 unapproved FY 2008 appropriations bills into a $484.2 billion omnibus package that would have divided the $22 billion difference between the amount of spending sought by Democrats and the amount requested by Bush (Kaiser Daily Health Policy Report, 11/26).

However, Bush "does not appear to be budging from his vow to veto spending bills, or an omnibus package, that would exceed his overall request," while Republicans "do not seem to be leaning on the White House to strike a deal, casting doubt on how this year's spending work will be completed," according to CQ Today. A conference meeting is expected to occur on Dec. 11, and lawmakers hope to send a spending package to Bush by Dec. 14, when the current continuing resolution expires. However, Democratic leaders "have changed their strategy for completing spending work several times this fall, meaning the timing and omnibus approach remain uncertain," CQ Today reports (Clarke, CQ Today, 11/30).

Efforts, Outlook on Omnibus Bill
Democrats "in hope of sweetening the pot to attract Republican support" for the omnibus spending package are "likely" to add "billions of dollars in emergency funds for border security, low-income heating and nutrition aid, and agriculture disaster relief," according to CongressDaily. The emergency funding designation means that the items can be included without being counted toward budget caps. According to CongressDaily, although Republicans "will likely object" to the strategy, the emergency funds that Democrats are considering "are so popular that, by combining them with regular spending on veterans' health care, homeland security and other bipartisan programs, it could prove difficult for Republicans to oppose" (Cohn [1], CongressDaily, 11/30).

Meanwhile, House Appropriations Committee Chair David Obey (D-Wis.) has proposed to cut earmarks in the remaining appropriations bills by another 50% in order to "blunt the attacks" from Republicans over spending, according to CongressDaily. However, Senate Democrats "are balking" about the proposed reduction and subcommittee chairs were "taken by surprise" by Obey's move, CongressDaily reports. The request "could threaten the timetable for completing work on the bills," which subcommittees were told to complete by Wednesday, according to CongressDaily. Senate Appropriations Committee Chair Robert Byrd (D-W.Va.) has said that the Senate does not agree with the additional cuts to earmarks. A spokesperson for Byrd said that senators are committed to "substantial reductions" in earmark levels from when Republicans controlled Congress (Cohn [2], CongressDaily, 11/30).

SCHIP
Legislation that would reauthorize and expand SCHIP "appears to be on life support," CongressDaily reports. House Majority Leader Steny Hoyer (D-Md.) on Friday announced that Democratic leaders have decided to send Bush an already-passed version of the legislation. Bush is expected to veto the bill, but Hoyer said that Democrats want to send the bill "because of concerns about a pocket veto if we wait" (CongressDaily, 11/30). Under a pocket veto, if Congress were to send the legislation to Bush less than 10 days before adjourning for the year, the president could kill the measure by refusing to sign it (Dinan, Washington Times, 12/3).

Bill supporters hope to schedule a veto override vote as early as this week, according to Carol Guthrie, a spokesperson for Senate Finance Committee Chair Max Baucus (D-Mont.) (USA Today, 12/3). Hoyer said that lawmakers would continue to work on a compromise. "Our bipartisan discussions on extending health insurance to 10 million children are ongoing," Hoyer said in a statement (Wayne, CQ Today, 11/30).

However, USA Today reports that a "compromise short of a veto override is unlikely." House Speaker Nancy Pelosi (D-Calif.) will not agree to covering fewer than 10 million children under the program, according to spokesperson Nadeam Elshami (USA Today, 12/3). With the CR that currently is funding SCHIP scheduled to expire Dec. 14, advocates have asked lawmakers to pass a new CR that would ensure that states have sufficient funds to maintain current enrollment levels in the program next year.

Medicare
Discussions about a Medicare package are "pushing full steam ahead," according to CongressDaily. The package includes measures backed by Baucus that would reverse for two years a scheduled 10% cut in reimbursements for physicians and would extend rural and low-income subsidies for beneficiaries.

Although committee members have not reached an agreement on all parts of the bill, aides said that the disagreements "narrowed considerably over the break" and "predict[ed] that a package would emerge" from the Senate Finance Committee with bipartisan support, CongressDaily reports. The committee might mark up the Medicare package this week.

Other Hearings
In addition, lawmakers this week will hold several hearings on health-related issues, CongressDaily reports. The House Energy and Commerce Subcommittee on Health on Tuesday will hold a hearing on measures to increase funding for community health centers, reauthorize health scholarships and student loan repayments programs, and establish school-based clinics. The House Energy and Commerce Committee this week is expected to mark up legislation to enhance the safety of consumer products.

The Senate Judiciary Committee on Tuesday will examine a federal ban on electronic prescriptions for controlled substances. In addition, the Senate Health, Education, Labor and Pensions Committee on Tuesday in a hearing will examine food safety that will feature testimony from HHS Secretary Mike Leavitt (CongressDaily, 11/30).

Reprinted with kind permission from http://www.kaisernetwork.org. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at http://www.kaisernetwork.org/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork.org, a free service of The Henry J. Kaiser Family Foundation© 2005 Advisory Board Company and Kaiser Family Foundation. All rights reserved