Having overcome several U.S. Senate attempts to make new Medicare and Medicaid cuts, healthcare providers are confident that the worst is over for this year.
No further moves to reduce federal expenditures for those two programs are expected when House and Senate conference committee negotiators start to settle the differences between their two budget bills, a process that's expected to begin as early as next week.
"We were most concerned about the Senate; I don't see any more cuts coming at this point," said Brent Miller, director of government affairs for the American Group Practice Association.
Late last month, the Senate voted 57-40 to approve a $1.5 trillion federal budget for fiscal 1995, beginning Oct. 1. The plan calls for $158.4 billion in total Medicare spending.
The Clinton administration's budget proposal called for restricting the growth of Medicare spending by $124 billion and Medicaid by $69 billion in the next five years. Any new cuts, such as those proposed in the Senate, would have been added to the Clinton restrictions.
During the next five years, the plan approved by the Senate would trim $26 billion in so-called "discretionary spending"-that is, spending for programs other than "entitlements," such as Medicare or Social Security-from the Clinton administration's proposed budget. But otherwise, the legislation largely follows the administration's proposal, with most of the cuts coming out of the Defense Department's budget.
The House passed its own budget resolution several weeks earlier. Its plan didn't include the additional $26 billion in cuts sought in the Senate bill.
The Senate budget represented a close call for providers. As the measure moved toward final passage, providers lobbied to kill a move by Sen. Pete Domenici (R-N.M.) to restore $20 billion of the $26 billion in discretionary spending cuts and instead take the money out of Medicare spending.
In the end, arguments by the Clinton administration and healthcare reform advocates such as Sen. Jay Rockefeller (D-W.Va.) that the additional Medicare and Medicaid cuts would make it impossible to finance healthcare reform carried the day. The measure was defeated by a vote of 63-35.
Included in the Senate budget was a non-binding "sense-of-the-Senate" amendment, introduced by Mr. Domenici and Sen. Sam Nunn (D-Ga.), that would cap entitlement spending after health reform was enacted. Budget Chairman Sen. James Sasser (D-Tenn.) and Mr. Rockefeller argued against the plan, which Mr. Sasser called "totally arbitrary spending reductions."