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Interests gear up for second budget vote

By OLGA PIERCE, UPI Health Business Correspondent

WASHINGTON, Jan. 24 (UPI) -- When the House passed the 2006 budget in the wee hours of the morning on Dec. 19, critics of the bill argued that it passed only because no one had time to read the 775-page document that was introduced just hours before the vote.

However, lawmakers have since had time to read it, thanks to maneuvering by Senate Democrats that will force the House to vote on the bill again Feb. 1. And a variety of groups representing the poor, senior citizens and the healthcare industry think they may actually force the House to vote against the budget and its controversial measures the second time around.

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Among the targeted features are provisions including a $42 billion reduction in Medicaid gross expenditures over the next 10 years; rule changes allowing states to limit benefits to children and stop covering family planning; limits on long-term care for seniors; and tighter restrictions on seniors who transfer assets to meet Medicaid income-eligibility requirements.

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"They've got to vote up or down on this again," Brad Woodhouse, communications director for the Emergency Campaign to Save America's Priorities, told United Press International. "We're in an election year now and we expect this will be an extremely close vote."

The campaign is a coalition of community and civil rights groups and unions that formed specifically to persuade the House to overturn its approval of the 2006 budget and to prevent further cuts for 2007.

Over the congressional break, local affiliates of the group visited members of Congress and invited them to "accountability sessions," town-hall style meetings where constituents asked them (or an empty chair if the representative declined to attend) to justify their vote for the cuts.

The group scheduled 185 events in January, such as one planned for Wednesday at a senior center in Illinois where group members plan to use Republican Mark Kirk's own scheduled event as an opportunity to ask him about his decision to vote for the budget.

In particular, the group has been targeting moderate Republicans who did not have time to familiarize themselves with eight new provisions that were added to the budget in conference committee, Woodhouse said.

After the budget-reconciliation vote, the House will have to vote on a tax-reconciliation bill that includes $70 billion in tax cuts that critics say primarily help the wealthy, a juxtaposition that could be used against members of Congress during upcoming election campaigns.

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The timing of the reconciliation vote also means that its deep program cuts will still be in recent memory when President Bush is expected to unveil his 2007 budget on Feb. 6.

"Members of Congress are going to hear from some angry constituents," Woodhouse said. "Then they're going to face this whole issue all over again. The president will have to respond to the reality that moderate Republicans don't want to have to walk the plank for special interest tax cuts."

Progressive groups are not the only ones opposed to the cuts who are paying close attention to the budget reconciliation vote.

House Ways and Means Committee Chairman Bill Thomas, R-Calif., was the target of a protest outside his Bakersfield offices Tuesday organized by a group called Last Chance for Patient Choice, which objects to language in the reconciliation bill that would require beneficiaries who use home medical equipment, such as oxygen therapy machines, to purchase their equipment instead of renting it.

The driving force behind the group is The VGM Group, an Iowa-based group of independent home medical equipment providers.

"Beneficiaries choose to rent rather than purchase because renting allows worry-free, professional maintenance of complex medical equipment and lowers costs to seniors," company spokesman John Gallagher said. "It is unconscionably unfair, dangerous and irresponsible for the government to literally force our senior Americans to take title to complex medical equipment after an arbitrarily capped rental period."

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The group has more protests planned in other congressional districts, Gallagher said.

The AARP issued a statement saying the bill contains provisions that would hurt seniors who take care of their grandchildren and might cost some seniors their homes because of tougher income-eligibility requirements for Medicaid.

Under the new rules, anyone with at least $500,000 in home equity would not qualify for Medicaid. In addition, seniors who transfer their assets to meet eligibility requirements must do it five years before they apply for Medicaid instead of three years, which opponents say will force middle-income seniors who cannot afford to pay for nursing homes to give up their houses and other assets earlier.

Supporters of the bill say that the cuts are necessary for fiscal responsibility, and the unusual second vote is a ploy to allow special interests more time to apply political pressure.

"The most important economic danger America faces over the next few decades is from unchecked federal spending," said Brian Riedl, a budget analyst at the Heritage Foundation in Washington.

"There's always a chance, when given an additional four weeks to hear lobbyists, lawmakers will change their votes," he told UPI.

The prolonged debate over the 2006 budget could also have an impact on the 2007 budget debate, especially if it includes additional cuts.

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"Reforms will be fresh in everyone's mind," he said. "Members of Congress may feel less pressure to enter another round of reforms this year."

But election-year anger from constituents may fail to materialize, he said, because the cuts are not actually as far-reaching as opponents claim.

"As a result of the bill, entitlement spending will grow 39 percent instead of 41 percent over the next five years," he said, adding that the amount of the cuts is small compared to the $873 billion the federal government is expected to spend on such programs by 2015.

"I think Americans are fed up with a federal government that has expanded 33 percent over the last four years. Lawmakers will be pleasantly surprised at their constituents' understanding of the need for reform," Riedl said.

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