Budget

Againt the deal from the right, Sen. Gramm (128K wav)

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Rep. Archer says this is only the beginning (192K wav)

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The Budget: A Look At The Spending Side

Important changes for Medicaid, new spending on children's health

WASHINGTON (AllPolitics, July 30) -- Though balancing the budget often conjures images of a grim reaper, this week's tentative budget accord substantially hikes spending for children's health and welfare recipients. Meanwhile, Medicare savings portend a restructuring of how seniors get their health care.

Children's advocates are rubbing their eyes in disbelief. Families USA, a health care interest group, called the budget "the most significant advance in funding for health care coverage since the Medicare and Medicaid programs were enacted 32 years ago."

Medicare changes

Some $115 billion will be squeezed from Medicare over the next five years, mainly through lower payments to hospitals, doctors and other care givers. That, says John Rother of the American Association of Retired persons, will likely ratchet up competition for seniors' business "in a major way."

In addition to traditional fee-for-service plans, lawmakers are allowing seniors to choose from more health vendors like health maintenance organizations (HMOs). Some 390,000 experimental medical savings accounts would allow seniors to purchase high-deductible catastrophic-care policies. Republicans have argued the approach puts the consumer more in charge of how health dollars are spent, and could help contain costs.

Also, by 2002 the $43.80 monthly premium for doctors' visits will rise to about $63.

Lawmakers dropped controversial provisions that would have raised the age eligibility from 65 to 67, imposed a $5 fee for home visits, and raised premiums for upper-income seniors.

With Medicare's long-term solvency still in question, however, those reforms aren't shelved permanently. Indeed, they are expected to be considered by a still-to-be-formed Medicare commission next year.

Children's health

Democrats are gleeful over $24 billion in new funds for states to expand health care coverage for children. The funds can be pumped into Medicaid or other existing insurance programs, and can also be used to create new ones.

"This historic investment in children's health is a major victory for America's children and working families," Children's Defense Fund President Marian Wright Edelman said in a statement.

Changes to welfare reform

Signing GOP-written welfare reform legislation last August, President Clinton vowed to "fix" what he said was wrong with the bill, notably the denial of welfare benefits to legal immigrants. Few thought he could overcome Republicans' objections to reopening the law, but the president appears to have succeeded.

Restored in the budget bill are disability and Medicaid funds for noncitizens currently on the rolls. And, legal immigrants who were in the country before the law was signed will be eligible for aid if they become disabled.

What has some Republicans fuming are provisions that would force states to pay the minimum wage to welfare recipients' who have state jobs.

"It's going to be terrible for everybody, including welfare recipients," Rep. Clay Shaw, a Florida Republican, told The Associated Press. "The states are simply not going to be able to afford to produce as many of the jobs that are needed."

Final votes on the budget bill, as well as the tax cutting bill, are expected this week.





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