HEALTH SPENDING: Congress, White House Reach Agreement
Wrapping up business before the end of the legislative session, the White House and congressional budget negotiators reached an agreement yesterday on a $500 billion omnibus federal budget bill that funds 10 federal departments. Agreements on health spending included:
- NIH: The National Institutes of Health received a $2 billion increase in funding, a "big infusion of extra money" that comes after a $900 million increase last year. The money will go to funding for biomedical research and "will enable the Centers for Disease Control and Prevention to start rebuilding local public health departments."
- HCFA: The Health Care Financing Administration's funding was boosted by $154 million, giving the agency added resources to "evaluate nursing homes, process bills, find Medicare fraud and abuse, and put insurance reforms for children and adults into effect." The Department of Health and Human Services, which oversees HCFA, will see an overall 10% jump in discretionary spending (Branigin et al, Washington Post, 10/16).
- Contraceptive Coverage: Federal employees will be entitled to contraceptive coverage under federal health plans, with exemptions for religiously affiliated plans and doctors with moral objections. The Los Angeles Times reports that Congress concluded "the only way to reduce the demand for abortion is to increase access to contraception." The new policy gives approximately 1 million women easier access to the pill, diaphragms, IUDs, Norplant and Depo-Provera and will likely serve as "a bellwether for other insurers nationally." The Times reports that "Congress appeared to be drawing an increasingly sharp distinction between reproductive health policies related to abortion and those involving contraception." (Rubin, 10/16).
- UN Family Planning: A deal that would have allotted $200 million in back dues to the United Nations fell apart, as President Clinton refused a Republican proposal that linked the money to the signing of a separate bill barring "federal grants to family planning organizations that lobby for abortion rights oversees." The New York Times reports that an anonymous congressional official blamed the White House for the impasse, saying, "The administration just won't bend on the abortion wording." Rep. Christopher Smith (R-NJ), the author of the original bill that would have restricted the funding to abortion rights groups, "watered down" his measure, removing the clause that would have also banned federal funds to groups that performed abortions. The Times reports that "[e]ven some lawmakers who support abortion rights had quietly urged the White House to accept" the deal. One Democratic congressional staffer said that "this is the best deal that the administration could ever get, and it's unfortunate that they wouldn't accept it" (Shenon, 10/16).
- Military Retirees: Under a three-year program included in the Defense Authorization Act, $100 million each year will go to fund a "test program that would allow military retirees to choose from the same health insurers that federal employees do." Retirees will be able to choose from "about 30 insurance providers and physicians in the civilian community." Approximately 60,000 former military personnel will be initially eligible (Joyner, Augusta Chronicle, 10/16).
Home Care Compromise Too Late?
CongressDaily reports that House and Senate negotiators reached a tentative agreement last night "on a bill to modify an interim payment system for Medicare home health care providers." Although the legislators missed by hours the deadline to include the home health care bill in the omnibus budget measure, "sources said an exception might be made to move home health as part of the broader measure." The $1.6 billion, five-year agreement was a compromise between the "slightly more generous" bill written by Sen. Phil Gramm (R-TX) and the "slightly less generous" proposal "passed by the House last Saturday." The compromise would "provide new funding and hold individual agencies 'harmless' from seeing payments reduced." It also further delays a scheduled 15% cut in Medicare home health payments by one year (Rovner, 10/16). An aide to Senate Labor and Human Resources Committee Chair Jim Jeffords (R-VT) said Jeffords "had gotten fellow senators to call" Senate Majority Leader Trent Lott (R-MS) "throughout the day Thursday to ask for restoration of the funding" (Gram, AP/Boston Globe, 10/16).
What Didn't Make It
Several provisions large and small that were dear to both Republicans and Democrats did not make it into the final budget agreement:
- A managed care reform bill that would have instituted a "patients' bill of rights."
- Comprehensive tobacco legislation (Hook, Los Angeles Times, 10/16).
- A measure extending the patents of brand name prescription drugs.
- A provision waiving the federal government's share to state tobacco settlements.
- A bill that would mandate insurance coverage of minimum hospital stays and reconstructive surgery for breast cancer patients.
- A measure that would have required parental consent or notification before a minor could receive contraceptives from a federally funded clinic (CongressDaily, 10/16).