House GOP Disagreements Raise Doubts About FY 2007 Budget Passage

Disagreements between House Republican moderates and conservatives over discretionary spending and appropriations rule changes have raised doubts about the passage of the fiscal year 2007 budget resolution, the New York Times reports (Hulse, New York Times, 4/3).

House Republicans on Thursday began discussions about the budget resolution, which the House Budget Committee approved on Wednesday. The House budget resolution includes $6.8 billion in spending reductions for entitlement programs but excludes reductions for Medicare and Medicaid.

In addition, the House budget resolution includes an $873 billion cap on discretionary spending requested by President Bush. Under the discretionary spending cap, spending for health and other nonsecurity programs would remain at about FY 2006 levels (California Healthline, 3/31).

According to the Times, conservatives are "balking at talk of exceeding the spending cap and want to put new budget rules in place to lower future spending" (New York Times, 3/3). The proposed appropriations rule changes, which have raised criticism from House Budget Committee members, include new rules on earmarks and emergency spending, as well as a "sunset commission" to discuss the elimination of some programs, CQ Today reports (Dennis, CQ Today, 3/31).

Meanwhile, moderates have requested $7 billion in additional discretionary spending to help nonsecurity programs that "have been shortchanged," according to the Times. The proposed 2% increase in discretionary spending for health, education and other programs -- supported by Rep. Mike Castle (R-Del.) and other moderates -- would move the House budget resolution closer to the Senate budget resolution passed last month (New York Times, 4/3).

The House could vote on the budget resolution as early as April 5, two days before a two-week recess begins (CQ Today, 3/31). House Republican leaders said that they expect the budget resolution to pass by a small margin (New York Times, 4/3).

In related news, Senate Finance Committee Chair Chuck Grassley (R-Iowa) and House Energy and Commerce Committee Chair Joe Barton (R-Texas) on Wednesday sent a letter to HHS Secretary Mike Leavitt to clarify two provisions in the FY 2006 budget reconciliation law (S 1932) (CQ HealthBeat, 3/31). President Bush on Feb. 8 signed the law, which contains $40 billion in spending reductions for Medicare, Medicaid and other programs (California Healthline, 2/9).

Opponents have said that the law allows states to increase cost sharing for Medicaid beneficiaries with annual incomes less than 100% of the federal poverty level and reduce benefits under the Medicaid Early and Periodic Screening, Diagnosis and Treatment program, which provides checkups to children.

In the letter, Grassley and Barton said, "Congress should not be presumed to have intended to have made so fundamental a change to the Medicaid program as allowing the imposition of unlimited cost sharing on the lowest income Medicaid beneficiaries." They added that, under the law, states must provide the same benefits under EPSDT as previously specified (CQ HealthBeat, 3/31).