Congress Approves Budget Plans, Sets Up Action on Health Reform

On Thursday, the House and Senate approved their respective versions of the fiscal year 2010 budget resolution (HConRes85, SConRes13), both of which include deficit-neutral reserve funds for health care, CongressDaily reports (Sanchez/Friedman, CongressDaily, 4/3).

The House passed its version of the resolution by a 233-196 vote, with no Republican support and 20 Democrats dissenting.

The Senate approved its version of the resolution by a 55-43 margin with no Republican support and two Democrats dissenting (Bendavid/Hitt, Wall Street Journal, 4/3).

The resolutions will go to conference committee, where lawmakers will craft a compromise resolution, after a two-week congressional recess (Lochhead, San Francisco Chronicle, 4/3). However, "House and Senate staff are likely to quickly begin informal discussions on melding the two chambers' bills," according to Roll Call (Stanton, Roll Call, 4/3).

Lead Up in the House

Before the House passed its version of the resolution, the chamber voted 293-137 to reject a Republican alternative budget (H.AMDT.75) (Espo/Taylor, AP/Houston Chronicle, 4/3).

Under the proposal, U.S. residents ages 54 and younger at the time of the bill's enactment would have, upon becoming eligible for Medicare at age 65, been enrolled in private health insurance plans and receive a subsidy on their premiums. U.S. residents ages 55 and older would still have been enrolled in the traditional Medicare program upon reaching the eligible age (California Healthline, 4/2).

Action in the Senate

According to The Hill, "The Senate budget differs from Obama's in that it contains fewer specifics on how to fund initiatives like health care reform" (Alarkon/Rushing, The Hill, 4/3).

Before the Senate passed its resolution, it voted on a number of amendments. The Senate approved an amendment (S.AMDT.759) that rejects Obama's plan to fund part of his health care expansion by reducing the tax deduction high-income U.S. residents can take for charitable donations.

Sen. Bob Bennett (R-Utah), who sponsored the amendment, said, "The Senate sent a clear message to the president that we do not support increasing taxes on charitable contributions to try to cover the costs of health care reform" (Rowland/Lengell, Washington Times, 4/3).

The Senate also voted 58-39 to reject an amendment (S.AMDT.805) by Sen. John Ensign (R-Nev.) that would have required beneficiaries of the Medicare prescription drug benefit who have annual incomes exceeding $85,000 for individuals or $170,000 for couples to pay a higher monthly premium than other enrollees (Clarke, CQ Today, 4/2).

The Senate voted 60-38 to reject an alternative budget proposal (S.AMDT.882) offered by Sen. John McCain (R-Ariz.) (Sanchez/McPike, CongressDaily, 4/2). McCain's plan called for a reduction in spending, largely from entitlement programs including Medicare and Medicaid (CQ Today, 4/2).

Prospects for Reform

The New York Times reports that the budget resolutions "provide an avenue for Congress to pursue a broad new national health care policy," among other items, "as long as the committees responsible for those issues find a way to keep the programs from adding to the deficit" (Hulse, New York Times, 4/3).

In addition, the resolutions "would permit work to begin on the central goals of Obama's presidency," including an expansion of health care coverage for the uninsured, the Washington Post reports.

According to the Post, the largest dispute between the House and Senate is whether to include budget reconciliation instructions to move health care legislation in the final compromise resolution (Montgomery, Washington Post, 4/3). According to the Washington Times, Democrats have indicated that they likely will include reconciliation instructions in a final House-Senate compromise resolution (Washington Times, 4/3).

McClatchy/Miami Herald on Thursday examined budget reconciliation and its potential use in health care reform (Lightman, McClatchy/Miami Herald, 4/2).

"Newsmaker" Interviews

On Thursday, PBS' "NewsHour With Jim Lehrer" included interviews with House Speaker Nancy Pelosi (D-Calif.) and House Minority Leader John Boehner (R-Ohio), during which the leaders addressed prospects for health care reform and other issues (Woodruff/ Holman, "NewsHour with Jim Lehrer," PBS, 4/2).