12-18-2000

POLITICS & POLICY - CONGRESS: APPROVES FINAL BUDGET DEAL, CALLS IT QUITS

 
      After a two-year 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 $20.3 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 also is an $825 million boost for CDC programs
 (Koszczuk, 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 (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).
      LOST IN 'GIVEBACK' PARADISE
      As part of the budget agreement, Congress also approved a
 Medicare and Medicaid "giveback" package, which spends about $35
 billion to providers and HMOs over five years, to expand Medicaid
 coverage and to help providers with the impact of the Balanced
 Budget Act of 1997 (Reuters/Houston Chronicle, 12/16).  This
 legislation invests about $35 billion over five years 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
 Fact Sheet, 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).  
      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).
 



American Healthline