The fate of Medicaid funding rests with a congressional conference committee, after the Senate passed a 2006 budget resolution with no Medicaid spending cuts, while the House approved roughly $20 billion in Medicaid reductions over five years. The Senate passed its $2.6 trillion budget plan on a 51-49 vote late Thursday night. Earlier in the day, it approved an amendment replacing all Medicaid cuts with a one-year commission on another narrow vote, 52-48. The House passed its 2006 budget resolution late afternoon by 218-214. The House resolution did not contain specific proposals to achieve the Medicaid savings; consumer advocates believe that appropriators will seek guidance from President Bush's budget, which calls for reducing mental-health services.
Provider groups called on Congress to adopt the Senate resolution, which included an amendment sponsored by Sens. Gordon Smith (R-Ore.) and Jeff Bingaman (D-N.M.). The amendment eliminated a requirement that the Senate Finance Committee cut $15 billion from programs under its jurisdiction, largely Medicaid, and mandated the creation of a bipartisan commission to consider long-term options for the program. Bush ignored the Senate plan and praised the House for a budget resolution that "closely follows my budget proposal and reflects our shared commitment to be wise with the people's money." Bush has called for about $60 billion in Medicaid savings over 10 years. A House-Senate conference committee is likely to begin reconciling differences between the two chambers' budget resolutions after Congress returns in April from a two-week recess. -- by Tony Fong