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).