In 1993, Sen. Daniel Inouye (D-Hawaii) sponsored a measure to guarantee $50 million in funds to help George Washington University Hospital in Washington build a new emergency room.
In 1994, then-Ways and Means Committee Chairman Dan Rostenkowski (D-Ill.), backed a proposal to help teaching hospitals, including Chicago's Northwestern Memorial, pay for capital projects like the $600 million building spree the hospital was on at the time.
Until the passage last year of a law granting the president veto power over individual spending measures, both of these proposals, like hundreds of other projects, couldn't be stripped out of a spending bill by the president.
But since Jan. 1, the president has had the line-item veto. If the measure survives a legal challenge, it could be used to pare spending from a number of health-related programs, including Medicare and Medicaid.
But while the power afforded the president under the line-item veto is far-reaching, experts say it is likely to be used sparingly.
"This is the biggest change in the way Washington does business in the last decade, not because it will be used all that often, but it gives the president new bargaining power," said Stan Collender, managing director of the federal budget consulting group at the public relations firm Burson-Marsteller in Washington.
The measure allows the president five days after he signs a spending bill to eliminate any measure that spells out a specific dollar amount. The only exception would be for existing entitlement spending. The power also applies to specific spending instructions that are sometimes included in the language that Congress sends along with spending bills to direct federal agencies on how Congress wants money spent.
What's more, the line-item veto law allows the president to eliminate any new measure in an entitlement program that would increase spending above what it would otherwise have been without the measure. For example, if Congress passed a new Medicare benefit that caused Medicare to spend more than it otherwise would have, the president could eliminate the measure.
"This could well reach beyond the traditional uses of the line-item veto," said Martin Corry, director of federal relations for the American Association of Retired Persons. "I don't think we know yet what will all be affected by this until the president begins exercising his authority and we see how creative he is."
If Rep. David Skaggs (D-Colo.) and five other lawmakers have their way, the president will never get a chance to exercise that power. Skaggs filed a lawsuit Jan. 2 challenging the constitutionality of the line-item veto on the grounds it violates the separation of the branches of government.
The Skaggs lawsuit, filed in U.S. District Court for the District of Columbia, will not be resolved until later this year, however.