- WASHINGTON - President Bush
is readying a new budget that would carve savings from Medicaid and other
benefit programs, congressional aides and lobbyists say, but it is unclear
if he will be able to push the plan through the Republican-run
Congress.
-
- White House officials are not saying what Bush's $2.5
trillion 2006 budget will propose saving from such programs, which comprise
the biggest and fastest growing part.
-
- But lobbyists and lawmakers' aides, speaking on condition
of anonymity, say he will focus on Medicaid, the health-care program for
low-income and disabled people. Medicaid costs are split between Washington
and the states.
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- Many expect him to propose giving states more flexibility
in using the $180 billion in federal Medicaid funds each year, but to limit
the program's growth on a per-patient basis - in effect forcing the states
to find ways to save money.
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- Bush may also propose trimming doctors' reimbursements
or weeding fraud from Medicare, the health insurance system for the elderly
and disabled, the aides and lobbyists said.
-
- He may seek savings from agriculture and other benefit
programs as well in the spending blueprint he will send to Capitol Hill
on Feb. 7.
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- There has not been a serious effort to pluck savings
from such programs - called entitlements because the benefits go
automatically
to anyone who qualifies - since 1997.
-
- After two straight record federal deficits that peaked
at $412 billion last year, many Republicans are eager to constrain
government
spending by curbing the growth of benefits. By law such programs, which
consume nearly two-thirds of the budget, grow to keep pace with inflation
and ever-larger numbers of recipients.
-
- Conservatives - including the chairmen of the House and
Senate budget committees, Rep. Jim Nussle (news, bio, voting record),
R-Iowa,
and Sen. Judd Gregg (news, bio, voting record), R-N.H. - may want to go
even further than whatever savings Bush proposes. Many of them consider
Bush's goal of halving the budget deficit by 2009 too timid, and see the
coming retirement of the 76 million baby boomers as threatening to snowball
federal spending.
-
- "There's this demographic tidal wave coming at
us,"
Gregg said in a recent interview. "We've got to adjust our retirement
structure to maintain a strong program for retirees" while making
sure younger people won't "be taxed to the point where their lifestyle
is significantly reduced."
-
- Other Republicans, recalling past Democratic attacks
when such programs were targeted, are wary. Veteran Rep. Christopher Shays
(news, bio, voting record), R-Conn., said many lawmakers would support
such cuts if they would balance the budget in the short term but would
be unwilling to "take a big hit" for incremental deficit
reduction.
-
- By proposing an overhaul this year of Social Security,
the biggest benefit program at more than $500 billion annually, Bush has
asked GOP lawmakers to risk angering senior citizens worried about the
retirement and pension program.
-
- Simultaneously pursuing savings from other programs would
only increase many legislators' heartburn.
-
- They would face the wrath of doctors - major GOP
contributors
- should Bush propose limiting the Medicare payments physicians receive.
Governors of both parties are already trying to head off any effort to
trim Medicaid, while farmers, veterans and other groups would be sure to
combat any efforts to curtail their benefits.
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- "It's obviously going to be a very difficult
lift,"
Nussle said recently.
-
- "Everyone has a program, everyone has a
constituency,
everyone has a point where they lose their courage to reform a government
that is too big," he said. "Republicans need to wake up. You
can't have tax cuts without spending restraint and get to a balanced
budget."
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- Among the fastest growing benefits is Medicare, which
increased by an estimated 8.1 percent last year and is projected to pass
$320 billion this year. Bush is considered unlikely to seek major savings
from a program to which he and lawmakers added expensive prescription drug
benefits less than two years ago.
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- According to Congressional Budget Office estimates last
fall, Medicaid spending grew by 9.4 percent while Social Security costs
expanded by 4.5 percent.
-
- The budget office projected last September that this
year's deficit will hit $348 billion, and stay in the $300 billion range
through 2010. The office plans to release its newest estimates on
Tuesday.
-
- In 1997 President Clinton and the GOP-run Congress
enacted
a compromise aimed at balancing the budget in five years. Most of the $130
billion in five-year savings came from reducing health providers' Medicare
reimbursements.
-
- That deal capped two years of battling in which Democrats
criticized then-House Speaker Newt Gingrich, R-Ga., for proposing Medicare
savings. Republicans suffered losses at the polls due to that clash, and
Gingrich said in an interview this week that for Bush to prevail this time,
he will have to persuade voters to support his proposed savings.
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