Congress Continues Work on Givebacks, Labor-HHS Spending

During a Dec. 7 meeting with Democratic and Republican congressional leaders, President Clinton urged lawmakers to "not give up" on passing the tax relief bill (H.R. 5542) that includes $35 billion in Medicare and Medicaid givebacks (H.R. 5542), CongressDaily/A.M. reports. Clinton "pressed aggressively" for proposals that would expand Medicaid coverage of disabled children and immigrants, hoping to attach such a provision to the givebacks bill. Clinton also "demanded that" the givebacks measure, intended to restore funding cut by the 1997 Balanced Budget Act, include more money for rural hospitals (Koffler et al., CongressDaily/A.M., 12/8). In response, Sen. Charles Grassley (R-Iowa) has been "working feverishly" to include a scaled down version of his Family Opportunity Act ( S. 2274), which includes proposals Clinton also was pushing for. Sen. Edward Kennedy (D-Mass.) also is a bill sponsor (Rovner, CongressDaily/A.M., 12/8).

Will It Pass?
House Majority Leader Dick Armey (R-Texas) "said that Congress would almost certainly reach an agreement" with Clinton on the givebacks measure. He added, "The Medicare agreements will easily be agreed to" (Pear, New York Times, 12/8). House Ways and Means health subcommittee Chair Bill Thomas (R-Calif.) also appeared optimistic, noting that "it was a good sign that the [Clinton] administration is now seeking only another $4.5 billion for the bill," instead of the $11 billion the White House previously proposed (Rovner, CongressDaily/A.M., 12/8). However, the Wall Street Journal takes a more pessimistic view, noting that "[s]ignificant disagreements" remain over the package (Rogers/Murray, Wall Street Journal, 12/8). The givebacks legislation still could be moved out of the tax bill, as "argued" by Republican Sens. Susan Collins (Maine) and Kay Bailey Hutchinson (Texas). The New York Times reports that congressional leaders "said they now expected to do just that" (New York Times, 12/8).

Cutting Back Labor-HHS
Also during the White House meeting, leaders discussed the Labor-HHS appropriations bill (H.R. 4577), as Republicans proposed cutting the $113 billion bill by $6 billion. However, CongressDaily/A.M. reports that the GOP leaders "did not put forth a detailed plan for trimming the measure." Sen. Tom Harkin (D-Iowa), the ranking Democratic member of the Labor-HHS appropriations subcommittee, said that the cuts would be "too deep," but "was optimistic that a final deal was in sight" (Koffler et al., CongressDaily/A.M., 12/8). Senate Majority Leader Trent Lott (R-Miss.) and House Speaker Dennis Hastert (R-Ill.) are "pressing" to strike a final agreement with Clinton before Monday night, the Washington Post reports (Pianin/Morgan, Washington Post, 12/8).

Fighting to Retain Proposed Increases
While lawmakers work to finalize new spending, the "health community now is scrambling to make sure Congress does not end up with a yearlong continuing resolution [funding for Labor-HHS] at last year's levels," CongressDaily/A.M. reports. Members of the Coalition for Health Funding -- including the American Academy of Pediatrics, American Heart Association, American Lung Association and the American Public Health Association -- "fanned out" on the Hill Dec. 7, "making it clear that last year's levels would be the worst possible outcome," CongressDaily/A.M. reports. For NIH, such a move would mean a loss of a $2.7 billion increase, according to Marcia Mabee, the coalition's executive director. The CDC would lose a proposed increase of $866 million, including increases of $88 million for HIV prevention, $36 million for childhood immunizations and $85 million for infectious disease control, CongressDaily/A.M. reports. Proposed increases of $150 million for community health centers, $245 million for a program to help children's hospitals pay for graduate medical education and $228 million in Ryan White CARE Act funds also are at risk (Rovner, CongressDaily/A.M., 12/8).