On June 4, the U.S. Senate voted 48–45 to approve a $3.1 trillion fiscal year 2009 budget resolution (S Con Res 70), which includes substantial increases in funds for domestic programs and excludes President Bush’s proposed funding cuts to Medicare and Medicaid. One day later, on June 5, the House passed the measure, marking the first time since 2000 that both chambers approved a budget resolution during an election year. The non-binding resolution lays out a spending blueprint that would increase funds for domestic Federal agencies by almost 5%, or $24 billion, and includes about $21 billion more than the President requested in discretionary spending—or about $1.013 trillion. With the budget framework resolution passed, Congress’ attention will now turn to the appropriations bills to determine how to spend the $3.1 trillion. House Appropriations subcommittees likely will begin to mark up the 12 appropriations bills next week, while the Senate will begin its mark up as early as June 16.     

Of particular interest to the health care community is the $250 billion supplemental Iraq War appropriations bill (HR 2642) that includes one-year moratoria on new Medicaid regulations proposed by the Bush Administration. Last week, House Appropriations Committee Chairman David Obey (D-WI) indicated his intention to eliminate moratoria on three important Medicaid regulations from the bill. The Senate and the House had previously passed versions of this bill with critical moratoria on all seven of the Administration’s damaging Medicaid regulations, a number of which significantly impact public and teaching hospitals. The three regulations in jeopardy are the hospital outpatient rule that heavily affects the New York City Health and Hospitals Corporation; the provider tax rule; and a targeted case management rule.  Apparently, Chairman Obey views these regulations as contentious provisions and has dropped them from the package to avoid drawing a veto from the White House. GNYHA has been aggressively working with its partners to ensure that the Iraq War Supplemental includes moratoria on all seven rules. The measure is expected to move to the House floor for a vote later this week.