The Senate on Thursday is expected to vote on the budget reconciliation bill (S 1932) after considering amendments, CongressDaily reports (Heil, CongressDaily, 11/3). The package, which was approved on Oct. 26 by the Senate Budget Committee, includes about $10 billion in cuts to Medicare and Medicaid approved by the Senate Finance Committee (Kaiser Daily Health Policy Report, 10/31). The bill is "likely to clear the chamber with relatively few changes, [although] the amendments will give senators the chance to highlight their priorities, and they might result in some tight votes," CongressDaily reports. Health care-related amendments include:A proposal by Sens. Olympia Snowe (R-Maine) and Ron Wyden (D-Ore.) that would allow the HHS secretary to negotiate with drug companies to lower drug prices for Medicare;

A proposal by Sen. Jeff Bingaman (D-N.M.) and others that would stop scheduled changes to federal Medicaid matching rates that would decrease funding for 30 states;

A proposal by Sens. John Kerry (D-Mass.) and Bill Nelson (D-Fla.) that would prevent an increase in Medicare premiums that would occur as a result of an increase in Medicare physician payment rates, which is part of the reconciliation package;

A proposal by Sen. Patty Murray (D-Wash.) that would give dual-eligibles an extra six months to pick a drug plan under the new Medicare drug benefit, which takes effect Jan. 1, 2006; and

A proposal by Sen. Blanche Lincoln (D-Ark.) that would redirect some of the $60 billion in Federal Emergency Management Agency funding provided by Congress after Hurricane Katrina to provide Medicaid coverage to hurricane survivors (CongressDaily, 11/3).

Possible Veto
CQ HealthBeat on Wednesday examined a White House statement on Tuesday that raises the possibility of a veto for the reconciliation bill if it eliminates a fund to encourage private insurers to participate in the Medicare drug benefit. The statement "appears to give Bush wiggle room since it does not specifically say that he will veto the bill, only that his advisers will urge him to do so" if Congress eliminates the fund, CQ HealthBeat reports. Eliminating the fund would save about $5.4 billion over five years (CQ HealthBeat, 11/2). According to CongressDaily, "some Senate Republicans questioned whether the White House would make good" on the veto threat (CongressDaily, 11/3). Senate Finance Committee Chair Chuck Grassley (R-Iowa) said, "Show me one bill the president's vetoed" (CQ HealthBeat, 11/2). Snowe said, "Some people think that's a veto threat, but I don't see it that way. I think it's less likely he would do it." However, a House Republican aide said the veto threat "strengthens the [House's] hand in conference" because it has not planned any cuts to Medicare spending (CongressDaily, 11/3). One health care lobbyist said the veto threat increases the likelihood that the House will agree to cuts in Medicare. A Senate Republican aide said, "Everybody in health care needs to be on guard until eggnog time" (CQ HealthBeat, 11/2).

House Budget Committee To Vote
In other budget reconciliation news, the House Budget Committee on Thursday is scheduled to vote on a reconciliation package that would reduce Medicaid spending by $12 billion. Committee Chair Jim Nussle (R-Iowa) said he has enough votes to pass the measure. However, the package faces "objections from various Republicans in anticipation of a [full] House vote next week," the Washington Times reports. House Speaker Dennis Hastert (R-Ill.) said he is confident Republicans will "come together and be united as a conference" to "get a bill we can pass." However, Rep. Michael Castle (R-Del.) said some Republicans are concerned that the House is voting on cuts "that aren't going anywhere in the Senate" (Fagan, Washington Times, 11/3).

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