Budget Reconciliation FY2006

Résumé du livre

"The House and Senate approved the conference report (H. Rept. 109-62) on H. Con. Res. 95, the Concurrent Resolution on the FY2006 Budget, on April 28 and April 29, 2005, respectively. The Senate Committee on Finance was instructed to meet a budget reconciliation target of 10 billion in direct spending savings over a five-year period, FY2006-FY2010. On October 25, 2005, the Senate Finance Committee reported its reconciliation proposal to the Senate Budget Committee, which subsequently incorporated the proposal into S. 1932, The Deficit Reduction Omnibus Reconciliation Act of 2005. In the House, the Committee on Energy and Commerce had budget reconciliation instructions that specified a mandatory savings target of 14.734 billion between FY2006 and FY2010. The Committee mark-up took place on October 27, 2005. Like a number of Senate committees, the Senate Committee on Finance achieves its reconciliation instruction budget mark through recommended program changes that result in direct spending increases as well as decreases. The Committee proposal focused on changes to the Medicaid, the State Children's Health Insurance program (SCHIP), and Medicare. Based on Congressional Budget Office (CBO) estimates, the largest Medicaid savings amounts are the result of changes in the reimbursement of outpatient prescription drugs. The Senate proposal would change some asset transfer rules for Medicaid-eligible individuals applying for long-term care services also resulting in estimated program savings. Additional Medicaid savings are estimated to occur as a result of changes to the program designed to combat fraud, waste, and abuse. Increases in Medicaid spending would result from temporary federal medical assistance percentage (FMAP) increases targeted to help Medicaid recipients in selected Louisiana parishes and counties in Alabama and Mississippi devastated by Hurricane Katrina, and also from the limiting of any FY2006-FY2007 FMAP decrease to Alaska. The proposal includes a number of Medicaid demonstration projects and some benefit and eligibility expansions. The SCHIP proposal would alter the method for redistribution of funds to the states. Medicare savings would result from changes in Medicare's Part C (Medicare Advantage) and the establishment of variations in provider payments that reflect quality differences (value-based purchasing or "pay for performance"). The proposal would also provide for a 1% Medicare payment update for physicians in 2006. In addition, there are other Medicare and Medicaid provisions. The House Energy and Commerce Committee limited its proposal to changes in the Medicaid program. The House Committee proposed reforms in the payment for prescription drugs, and asset transfer rules for long-term care Medicaid-eligible individuals. Other provisions in the House would alter Medicaid's cost-sharing requirements, allow for the use of actuarial-equivalent benchmark insurance packages, and would allow for Health Opportunity Account demonstration projects. The House recommendation also provides Katrina relief. This report will be updated to provide a summary of all the major provisions in the Committee's recommendations.