Congress is set to nearly double what President Bush wanted to set aside from the projected federal budget surplus to fund Medicare reforms and to cover seniors' prescription-drug costs.
Although congressional leaders had hoped to vote last week on the legislation, a last-minute dispute over funds to pay for health coverage for poor people led to a delay in the vote until this week.
Congress' final compromise budget blueprint for fiscal 2002 earmarks up to $300 billion over 10 years to fund the reforms and add a prescription-drug benefit to Medicare. House and Senate leaders were preparing to vote this week on the blueprint, a congressional resolution that sets spending targets to be enacted through separate legislation later this year. The blueprint-which represents a negotiated version of House and Senate proposals-doesn't require Bush's signature.
In supporting the $300 billion figure, House-Senate negotiators backed the amount the Senate approved earlier this year. The House and President Bush had supported $153 billion to fund a reform package and seniors' prescription-drug purchases. Drug costs now are borne by seniors and their Medicare supplemental health plans.
At deadline, it was not clear whether any of the $300 billion would come from the Medicare Hospital Insurance Trust Fund, which provider groups say should be untouched.
Bush and congressional leaders are calling for summer passage of legislation that will reshape Medicare into a system under which the federal government pays for most, but not all, of seniors' premiums for joining private-sector health plans.
The resolution also sets aside $28 billion over three to 10 years to expand health-insurance coverage for the uninsured, including tax credits for uninsured people buying health insurance and expansions in Medicaid and children's health programs.
Richard Pollack, executive vice president of the American Hospital Association, said that pool of money gives Congress an "opportunity to improve the healthcare delivery system."
That money became the subject of an 11th-hour spat in the Senate, when Sen. Phil Gramm (R-Texas) tried to require that the money be distributed over 10 years. The last-minute negotiations delayed the vote until this week.
Even though the compromise was announced last week, explanatory documents weren't immediately available. That, in part, resulted from the negotiations over the funds for the uninsured.
As a result, it wasn't clear whether Congress would call for an increase in funds to train health professionals to help alleviate a healthcare workforce shortage. Bush's budget proposal called for cutting such programs funded through the Health Resources and Services Administration by 60% from 2001 to 2002.
Hospital groups, including the AHA, have been pushing Congress to take action to help alleviate the shortage. Among their proposed solutions is an increase in Medicare payments (See story, p. 12).