Congress Approves Final Budget Deal, Adjourns
After a two-year congressional session marred by "bitter but futile" fights over health care policy, Republicans and Democrats Friday agreed to a $450 billion budget package, which included a $108.9 billion Labor-HHS appropriations bill "hung up" by months of "political jousting," and adjourned for the year, the Miami Herald reports. The House passed the budget deal 292-60, while the Senate approved the legislation by voice vote (Koszczuk, Miami Herald, 12/16). The Labor-HHS bill includes $20.5 billion in NIH funding for medical research and clinical trials -- nearly double the $10.3 billion spent in 1993 (White House release, 12/15). There is an $825 million boost for CDC programs (Miami Herald, 12/16). After passing the measure, Republicans "claimed" victory, touting the "record increases" in NIH funding (Pianin/Morgan, Washington Post, 12/16). Under the deal, GOP lawmakers ended their fight against ergonomics rules issued by the Clinton administration in the hope that President-elect George W. Bush "will halt the new rules by executive order" (Koszczuk, Philadelphia Inquirer, 12/16). The agreement, which prevented a "shutdown of unfunded federal agencies," also included $1.8 billion in Ryan White CARE Act funding -- an increase of $213 million over the previous year. But it excluded tax cuts for health care costs and the Pain Relief Promotion Act, legislation that would have effectively overturned Oregon's landmark assisted suicide law (Masterson, Houston Chronicle, 12/16). The law also includes $235 million to reimburse independent children's hospitals for training pediatricians (Kirchhoff, Boston Globe, 12/16).
'Givebacks' Help Providers and Beneficiaries
As part of the budget agreement, Congress also approved a
Medicare and Medicaid "giveback" package, which will allot about
$35 billion to providers and HMOs over five years, expanding
Medicaid coverage and helping providers with the impact of the
Balanced Budget Act of 1997 (Reuters/Houston
Chronicle, 12/16). This legislation invests the total
funding with approximately $5 billion for Medicare and Medicaid
beneficiary improvement; $12 billion for hospitals; $2 billion
for nursing homes; $2 billion for home health agencies; $3
billion for other providers; and $11 billion for managed care
plans. Of this, about $2 billion is dedicated to rural providers
(White House release, 12/15). The bill also provides a range of
expanded benefits for Medicare beneficiaries, including colon
cancer, glaucoma and pap smear screenings, and waives a two-year
waiting period for Medicare eligibility for those suffering from
Lou Gehrig's disease (Reuters/Houston Chronicle,
12/16). In addition, the package includes a provision that
allows the government to levy a $100,000 fine on health plans
exiting Medicare mid-year and allows states to identify children
eligible for Medicaid at schools, public housing projects and
Indian reservations (Washington Post, 12/16).
Lawmakers Tout Deal
The "anticlimactic" budget compromise, which ended weeks of
wrangling between GOP leaders and President Clinton, also brought
swift reactions from lawmakers. According to House
Appropriations Committee Chair Bill Young (R-Fla.), "It has been
a long process, but in the end we believe we've struck a
responsible balance between increasing funding for education and
medical research without overburdening the American taxpayer"
(Miami Herald, 12/16). House Speaker Dennis Hastert
(R-Ill.) praised the agreement, calling it "good for the future
of our nation's health" (Connor, New York Post,
12/16). He added, "Today, through compromise, Democrats and
Republicans came together in the Congress" (Masterson,
Houston Chronicle, 12/16). Senate Health,
Education, Labor and Pensions Committee Chair James Jeffords (R-
Vt.) agreed, noting, "It took us longer than it should, but it
looks like we've finally gotten there" (Kelley, Gannett
News Service/Boston Herald, 12/16). Sen. Ted Kennedy (D-
Mass.) added, "While this legislation is not perfect and
certainly is no substitute for the unfinished work of the 106th
Congress ... it shows what is possible when we resolve to work
together" (Boston Globe, 12/16). However, Rep. Pat
Toohey (R-Pa.), opposed the deal. "Frankly, we're squandering
too much of the budget surplus that could be used for other
purposes," he said (New York Post, 12/16).
Congress Leaving a 'Do-Nothing' Legacy?
According to the New York Times, however, most
lawmakers "slipped out of town, too weary for even the usual
self-congratulatory press conferences," with congressional
leaders telephoning Clinton "simply to call it quits"
(Clymer/Alvarez, New York Times, 12/17). The
AP/Richmond Times-Dispatch also reports that the
106th Congress, "one of the most partisan in recent history,"
failed to pass key health care legislation, including a patients'
bill of rights, a prescription drug benefit for seniors and
Medicare reforms. "It was a housekeeping session. There were
lots of small things passed, but nothing that will dramatically
change American lives," University of Virginia Professor Larry
Sabato said. "This Congress wasted its energy," Rep. Nancy
Pelosi (D-Calif.) added (AP/Richmond Times-Dispatch,
12/17). Still, a "disappointed" Senate Minority Leader Tom
Daschle (D-S.D.) said that health care issues would remain "top
priorities" next year, regardless of President-elect George W.
Bush's agenda (New York Times, 12/17).