House Passes Budget Reconciliation Bill, 227 - 203;
Senate Vote Expected Today

The White House
202-456-1414

US Senate
202-224-3121

US House
202-225-3121

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The US House of Representatives Thursday passed a budget bill dramatically altering the federal government's responsibility to provide health care and social services, while cutting taxes by $245 billion. Of primary importance to people with HIV/AIDS, the bill dismantles the federal Medicaid program, replacing it with block grants to the states, removing many federal standards of care, allowing states to set their own eligibility criteria and benefits, and cutting program spending by $182 billion. Additionally, the Budget Reconciliation bill ends the entitlement status for welfare; slashes the Medicare program and the federal student loan program; and reduces the Earned Income Tax Credit for the working poor. The Senate today continues debate and a vote is expected late this afternoon on their slightly more moderate version of the bill. President Clinton has vowed to veto the final bill. Democrats have called the Republican budget an assault on the poor, the disabled, and the elderly. Some Republican moderates have expressed concern about these drastic Medicaid reforms.

The House:

The House vote, mostly along party lines with a few defectors on each side, reflected strong Republican support for this centerpiece of the Republican "Contract with America." One helpful provision was discussed on the House floor. It encourages the states to expedite eligibility determinations for Medicaid for people with life-threatening conditions.

With the exception of four members, all Democrats opposed the bill. Democrats voting YES were: Parker (MS), Montgomery (MS), Hall (TX), and Geren (TX). [Take note of these votes. These members need to hear your displeasure]

With the exception of ten members, all Republicans supported the bill. Republicans voting NO were: Scarborough (FL), LaHood (IL), Morella (MD), LoBiondo (NJ), Saxton (NJ), Smith (NJ), Zimmer (NJ), Boehlert (NY), McHugh (NY), LaTourette (OH). [Thanks are in order to these Republican members who face strong opposition from the leadership in the House]

The Senate:

The Senate is expected today to vote and pass its version of the Budget Reconciliation Bill. After the Senate vote, the bill will then go to conference committee to negotiate the differences before a final version goes to President Clinton for his signature or veto.

Debate continues with all manner of amendments being offered as the time for debate begins to run out. In an effort to win votes from moderate Republicans, Majority leader Dole (R-KS) promises to fight for passage of a "leadership amendment" which would restore $18.2 billion to the budget. Dole also promised an additional $10 billion to adjust the Medicaid block grant formula to benefit Alabama, Arizona, Maine, Missouri, Texas, and Vermont.

The following are a few amendments offered in the Senate that have particular significance for people with HIV/AIDS:

Rockefeller (D-WV) - Motion to recommit the bill (Medicaid) to the Finance Committee for 3 days with instructions to guarantee a defined basic benefit package for coverage for pregnant women living under 185% of federal poverty guidelines, all children up to age 19, and individuals with disabilities living under 100% of federal poverty guidelines. This motion was important because it tried to restore both Medicaid's entitlement status and a federally defined benefits package. Defeated 46-53.

Graham (D-FL) - Motion to recommit the bill (Medicaid) to the Finance Committee with instructions to re-write the bill with no more than $60 billion in cuts over seven years. The amendment instructed the committee to get additional revenue for Medicaid by reducing the tax cut for upper income taxpayers. It further instructed the committee to achieve the savings through implementation of a per capita cap rather than a block grant, and to continue coverage protections and quality assurances. Defeated 51-48.

Chafee (R-RI) - Guaranteed coverage for low income people with disabilities, and for individuals eligible for SSI, as amended by the Welfare Reform bill. (The SSI definition of disability includes very low income people unable to work for at least one year, or people who have a disability which is expected to end in death. The welfare reform bill further limits eligibility for SSI by placing severe limits on eligibility for individuals whose applications are based on a history of drug or alcohol dependency unless they can make a claim based upon some other disabling condition -- such as TB or HIV/AIDS. The eligibility limits for legal immigrants are just as severe; disqualifying all non-citizens until they have worked for 40 quarters -- about 10 years). This amendment PRESERVES Medicaid entitlement status for some people with AIDS; however, those eligible under the current medically needy category would not be covered. Also, NO BENEFITS are defined; therefore it is not clear as to which medical services people will be entitled. Passed 60-39.

AIDS Action:

1. Encourage your representatives and senators to support the Chafee (R-RI) amendment to include guaranteed eligibility for some people with disabilities. Also encourage them to require expedited eligibility approval for people with life-threatening conditions.
2. If your member of Congress voted "NO" on Budget Reconciliation, thank him/her for their vote. If he/she voted "YES", express your displeasure.
3. Urge President Clinton to VETO the Budget Reconciliation Bill and to restore the Medicaid entitlement.
4. Look for our next Alert for information on the final Senate Vote.

For more information, contact:
AIDS Action Council
1875 Connecticut Avenue NW #700
Washington DC 20009
202-986-1300
202-986-1345 (fax)
202-332-9614 (tty)
E-Mail: aidsaction@aidsaction.org