President Bush Promotes FY 2006 Budget Proposal; Some Lawmakers Criticize Medicaid Provisions
Reaction to the $2.57 trillion fiscal year 2006 federal budget proposal that President Bush submitted to Congress on Monday indicates the president "has a lot more selling ahead of him," as many lawmakers "found something not to like on Mr. Bush's long list of proposed cuts" to health care and other programs, the Wall Street Journal reports (McKinnon/Murray, Wall Street Journal, 2/9).
The budget proposal, which includes a 1.2% decrease in discretionary funds for HHS, with significant reductions in funds for CDC and other agencies, a 17% increase in funds for Medicare and a plan to save $60 billion over 10 years in Medicaid funds through the removal of state reimbursement "loopholes" and tighter eligibility requirements. The budget proposal also would eliminate 150 domestic programs to save the federal government $20 billion annually.
In addition, the budget proposal includes reductions of $60 billion in Medicaid funds over the next 10 years through a number of provisions, such as limits on state claims for federal matching funds, restrictions on transfers of assets by seniors to obtain Medicaid eligibility and reductions in reimbursements for prescription drugs (California Healthline, 2/8).
In a "lectern-thumping" speech on Tuesday to the Detroit Economic Club, Bush "left little doubt he intends to take the battle for his domestic agenda on the road this year, despite the grumblings" from lawmakers about "steep Medicaid cuts" and other provisions in the budget proposal, the Journal reports (Wall Street Journal, 2/9).
"We will insist on a budget that limits and tames the spending appetite of the federal government," Bush said (Hook/Vieth, Los Angeles Times, 2/9). He added, "It is essential that those who spend the money in Washington adhere to this principle: A taxpayer dollar ought to be spent wisely or not spent at all" (Wall Street Journal, 2/9).
Bush also addressed criticism that his budget proposal would result in reductions in programs that help low-income U.S. residents, such as Medicaid. "Every government program was created with good intentions, but not all are matching good intentions with good results," he said. Bush also said that his proposals to limit medical malpractice lawsuits and allow small businesses to establish association health plans across state lines indicate that the nation is "moving forward with an ambitious agenda to ensure that our economy remains the freest, the most flexible and the most prosperous in the world" (Loven, AP/Indianapolis Star, 2/9).
Office of Management and Budget Director Joshua Bolten on Tuesday told the House Budget Committee that Bush "won't hesitate" to veto FY 2006 appropriations bills (AP/St. Petersburg Times, 2/9). However, Bolten added, "I don't anticipate it will be necessary this year" (Arkansas Democrat-Gazette, 2/9).
"Fractures among Republicans emerged on Capitol Hill" over the budget proposal on Tuesday, but GOP congressional leaders "generally endorsed" the amount of funds allocated under the plan, the Los Angeles Times reports. Senate Finance Committee Chair Chuck Grassley (R-Iowa) said, "It's not going to come out exactly what the president has suggested, although I think the bottom line -- the total amount of spending -- will come out very close to where he is" (Los Angeles Times, 2/9).
Two Republican congressional leaders also "put lawmakers on notice that they intend to push through painful cuts in mandatory spending, including Medicare and Medicaid," CQ Today reports (Schatz, CQ Today, 2/8). Grassley said that lawmakers would work with governors on the proposed Medicaid reforms, adding, "We're going to have to be very careful" to ensure that Republicans are not seen as "hammering the poor" (Schatz, CQ Today, 2/8).
House Majority Leader Tom DeLay (R-Texas) said, "I think the president is absolutely courageous ... to take on all mandatory programs and making the point that if we're going to get our fiscal house in order they will have to be included."
Senate Budget Committee Chair Judd Gregg (R-N.H.) said that the budget proposal addresses "specifically the issue of entitlement spending, especially in the area of health care and Medicaid. ... And it is those entitlement programs which we as Congress have an obligation to fix today so that they don't end up bankrupting our children and our children's children tomorrow" (Cohn/Davis, CongressDaily, 2/9).
However, Gregg said that he found a number of provisions in the budget proposal that he would not support (Hutcheson, Knight Ridder/Contra Costa Times, 2/9). Gregg said that Congress must "slow the rate of growth" in Medicaid with legislation to provide states with "a little less money with a lot more flexibility" (Angle/Schatz, CQ Today, 2/8).
Some Republicans said that Bush "will have to weigh in more heavily" than in past budget debates if he expects Congress to "scale back popular programs -- including entitlements," such as Medicare and Medicaid, the Los Angeles Times reports (Los Angeles Times, 2/9). Sen. Olympia Snowe (R-Maine) said, "I don't think it's realistic. I think a lot of the cuts (would be) devastating," adding, "We will all weigh in accordingly" (Schatz, CQ Today, 2/8).
Democrats on Tuesday criticized the budget proposal, which they said sought to balance the federal budget though reductions in funds for domestic programs that help low-income residents. "The cost of the deficit should not be borne by those who are least able to afford it," Rep. Rosa DeLauro (D-Conn.) said (Angle/Schatz, CQ Today, 2/8).
Rep. Steny Hoyer (D-Md.) said, "We believe that many of his proposals are going to be overwhelmingly rejected by the American people. I think (Republicans) will pay a very large political price" if the proposed Medicaid reforms and other provisions in the budget proposal are enacted (Mason/Martinez, Houston Chronicle, 2/9).
Sen. Max Baucus (D-Mont.), ranking member of the Senate Finance Committee, who has indicated that he might oppose the proposed Medicaid reforms, said in a statement, "We need to tread very carefully here" (Schatz, CQ Today, 2/8).
Rep. Mel Watt (D-N.C.), who as chair of the Congressional Black Caucus discussed racial disparities in health care with Bush in a January meeting, said, "How are you going to close the disparity instead of widening the gap if you don't put resources into (programs)? It's all about interdependence" (Holmes, AP/Raleigh News & Observer, 2/9).
The office of Sen. Edward Kennedy (D-Mass.) added that the budget proposal would "sharply cut" funds from programs to train new physicians in teaching hospitals. "America faces a health care crisis, and ... instead of responding to the challenge, the Bush budget is a step backward," Kennedy said in a statement (Crittenden, Boston Herald, 2/9).
Veterans groups criticized a provision in the budget proposal that would increase fees for health care for veterans (Dethman, Deseret Morning News, 2/8).
The budget proposal would require about two million higher-income veterans without service-related conditions to pay a $250 annual fee, as well as an $8 increase in copayments for prescription drugs, for FY 2006. Under the proposal, total funds for the Department of Veterans Affairs would increase to $68.2 billion, or by 1%.
The budget proposal would eliminate federal funds for a program that provides long-term care for veterans and reduce funds for VA nursing home care by $351 million, which could lead to the elimination of about 5,000 nursing home beds administered by the department (American Health Line, 2/8). Bush in the last three years has failed to convince Congress to pass similar reforms to the VA health care system (Deseret Morning News, 2/8).
Reps. Darlene Hooley (D-Ore.) and Brian Baird (D-Wash.) said that they would seek $1.3 billion in funds for the VA health care system. Hooley said, "We made a promise to all of our veterans to take care of them. We're not doing a very good job, and we've got a whole new group coming back" (Larabee, Oregonian, 2/8).
Thomas Cadmus, national commander of the American Legion, said, "It is incomprehensible that our veterans will pay for the shortfall in VA health care funding from their own pockets as tax dollars flow out the back door of America" (Deseret Morning News, 2/8).
The Government Accountability Office on Tuesday released a report that said unfunded, long-term liabilities in the federal budget would amount to $43 trillion over 75 years, unless Congress makes "significant policy" changes to "fundamentally" revise mandatory expenditures and tax laws, CongressDaily reports. GAO Comptroller General David Walker on Tuesday told the Senate Budget Committee, "Simply put, our nation's fiscal policy is on an unsustainable course and our long-term fiscal gap grew much larger in fiscal 2004."
Walker said that Medicare and related prescription drug costs accounted for $27 trillion and $43 trillion in unfunded liabilities, respectively, adding that the problem "is too big to be solved by economic growth alone or by making modest changes to existing spending and tax policies" (Posner, CongressDaily, 2/9). Walker said, "There is no way we are going to deliver on all the promises that have to be made, no way," adding, "We're going to have to do it in increments, it's too heavy a lift" (Hutcheson, Philadelphia Inquirer, 2/9).
Sen. Kent Conrad (D-N.D.), ranking member of the committee, said that lawmakers should pass Social Security and Medicare reforms to help reduce unfunded liabilities (CongressDaily, 2/9).
Walker said, "The fundamental difference is that health care is much more complex, and it will be very heavy lifting and labor intensive for many years. You can restructure Social Security ... in such a way that everybody gets more than they think they will, but you don't have a prayer of doing that with health care" (DeBose, Washington Times, 2/9).