Senate, House Delay Votes on Supplemental War Appropriations Bills With Provisions To Delay Medicaid Regulations

The Senate Appropriations Committee on Thursday delayed a scheduled mark up of a $193 billion supplemental war appropriations bill that includes a provision to block for one year seven new Medicaid regulations proposed by the Bush administration, as well as additional funds for FDA, CQ Today reports. According to CQ Today, committee Chair Robert Byrd (D-W.Va.) decided to move the mark up to May 15 at the request of Senate and House leadership after "dissension forced House Democrats to delay until next week bringing the supplemental [bill] to the floor."

The Senate version of the bill includes $275 million for FDA, $400 million for NIH to fund about 700 research grants, $437 million for the construction of polytrauma centers administered by the Department of Veterans Affairs and $350 million for hospitals in Louisiana and Mississippi as part of relief from Hurricane Katrina.

In addition, the legislation includes a provision that would ban construction of new physician-owned specialty hospitals. The provision also would require the 100 to 200 specialty hospitals currently in operation to disclose their ownership interests to patients. According to a Senate Republican aide, the provision would save $2.4 billion over 10 years, in large part through decreased growth in the number of medical procedures billed to Medicare (Higa/Clarke, CQ Today, 5/8).

According to the Washington Post, the bill might "face a Republican filibuster because of its price tag, raising the possibility that the Senate would turn to the House bill," but, "if Democrats can round up the 60 votes needed to fight off GOP objections," the Senate will "send a bill with war funds and domestic spending back to the House" (Kane, Washington Post, 5/9).

Grassley Seeks Removal of Medicaid, Specialty Hospital Provisions
Senate Finance Committee ranking member Chuck Grassley (R-Iowa) on Thursday asked Byrd and Senate Appropriations Committee ranking member Thad Cochran (R-Miss.) to remove the Medicaid provision and the specialty hospital provision from the Senate version of the bill, CongressDaily reports. In a letter to Byrd and Cochran, Grassley wrote that the provisions "should only be considered by the Finance Committee," which has "done significant work on this issue over the years including holding hearings and conducting investigations."

However, Senate Finance Committee Chair Max Baucus (D-Mont.) supports the inclusion of the provisions in the legislation, according to a Senate aide (Edney, CongressDaily, 5/9).

Blue Dog Coalition Opposition
In the House, a "revolt" by the Blue Dog Coalition has prompted Speaker Nancy Pelosi (D-Calif.) to delay a floor vote on the House version of the bill until next week, CQ Today reports. The coalition opposes the legislation because of a lack of offsets for some of the funds that the bill would provide.

Coalition leader Rep. Allen Boyd (D-Fla.) said that he has begun to work with the House Ways and Means Committee to find offsets for the funds. Mike Ross (D-Ark.), coalition co-chair for communications, said that an "overwhelming majority" of coalition members will oppose the legislation without the offsets (Higa/Clarke, CQ Today, 5/8).

According to the Post, without the votes of "most of the 47 Blue Dogs, the domestic spending provisions would have great difficulty passing the House" (Washington Post, 5/9). House Democratic leaders plan to move the bill to the floor on May 14 (Higa/Rogin, CQ Today, 5/8).