Senate Approves Supplemental War Spending by Veto-Proof Majority; Bill Includes Moratorium on Medicaid Regulations

The Senate on Thursday approved a supplemental war appropriations bill (HR 2642) that would place a one-year moratorium on seven new Medicaid regulations proposed by the Bush administration, the New York Times reports (Pear, New York Times, 5/23). The bill, approved on a 70-26 vote, also includes $1.2 billion for scientific research (Miller, Washington Times, 5/23). NIH would receive an additional $400 million under the bill. In addition, the bill includes $437 million for veterans trauma centers (Taylor, AP/Chicago Tribune, 5/22). The bill also would provide additional funding for FDA (Weisman, Washington Post, 5/23).

The Senate voted 75-22 to adopt the domestic spending amendment to the bill. Senate leaders were planning to remove the domestic spending provision if it did not receive 60 votes (Higa, CQ Today, 5/22). The bill will now be sent back to the House, which is expected to vote on the measure after the Memorial Day recess (Washington Post, 5/23). After the vote, Sen. Charles Schumer (D-N.Y.) said, "We are one step closer to making sure these devastating regulations never see the light of day" (New York Times, 5/23).

President Bush has said he will veto the bill because it includes domestic spending that exceeds his total cap of $108 billion. White House spokesperson Dana Perino said, "There's a long way to go in this process, and fortunately it takes two houses of Congress to send a bill to the president," adding, "Our position hasn't changed: This is the wrong way to consider domestic spending, and Congress should not go down this path."

Prospects
According to the Washington Post, "The fate of the Senate package is unclear," and although the "legislation would probably gain majority support in the House if Speaker Nancy Pelosi (D-Calif.) put it to a vote," the bill "has serious problems in her fractious Democratic caucus." Many antiwar Democrats in the House oppose the war provisions in the bill "especially if they are not accompanied by binding language to bring combat forces home," while the Blue Dog Coalition objected to some domestic spending measures not having offsets, according to the Post.

House Democratic Caucus Chair Rahm Emanuel (Ill.) said he expects Congress to send the bill to Bush in June -- with the domestic spending provision (Washington Post, 5/23). Sen. Byron Dorgan (D-N.D.) said it would be "pretty hard" for Bush to veto the Senate version of the bill. According to CQ Today, "Several Republicans agreed with Dorgan." Sen. Mel Martinez (R-Fla.) said, "It was a veto-proof vote, so it will make the veto harder" (Higa, CQ Today, 5/22).

Leavitt Offers Compromise
HHS Secretary Mike Leavitt on Wednesday said he would voluntarily delay until Aug. 1 two of the seven Medicaid rules affecting hospital payments, CQ Today reports. The two rules deal with Medicaid payments to public hospitals and federal Medicaid reimbursements for medical interns and residents who receive their training at hospitals. Without a delay, the regulations would take effect on May 25. In a statement, Leavitt said, "I reiterate the administration's willingness to work with Congress and governors to discuss their concerns before the rules go into effect."

Public hospital officials have said the rules would cost them millions of dollars in revenue. Larry Gage, president of the National Association of Public Hospitals and Health Systems, said, "I think it was an effort to provide the Senate Republican leadership something to point to in their unsuccessful effort to fend off the (moratorium) amendment in the Senate." Gage said a federal judge on Friday is expected to issue a ruling that might further delay the rule that would limit payments to public hospitals (Wayne, CQ Today, 5/22).