Efforts by Senate Republicans to remove two Medicaid provisions from a $193 billion supplemental war appropriations bill "have been rebuffed by Democrats," CQ Today reports (Armstrong, CQ Today, 5/9). Senate Finance Committee ranking member Chuck Grassley (R-Iowa) on Thursday in a letter asked Senate Appropriations Committee Chair Robert Byrd (D-W.Va.) and ranking member Thad Cochran (R-Miss.) to remove a provision that would block for one year seven new Medicaid regulations proposed by the Bush administration, as well as a provision that would ban construction of new physician-owned specialty hospitals.

In the letter to Byrd and Cochran, Grassley wrote that the provisions "should only be considered by the Finance Committee," which has "done significant work on this issue over the years including holding hearings and conducting investigations." However, Senate Finance Committee Chair Max Baucus (D-Mont.) supports the inclusion of the provisions in the legislation, according to a Senate aide (Kaiser Daily Health Policy Report, 5/9).

According to CQ Today, Baucus says Republicans already have blocked efforts to address the Medicaid rules in a stand-alone bill (HR 5613). Baucus spokesperson Carol Guthrie said, "Senator Baucus has said that in light of the fact that efforts to move legislation stopping these bad Medicaid (regulations) from being implemented have been blocked, the supplemental funding bill is a viable vehicle for moving them forward."

Jesse Jacobs, a spokesperson for Byrd, said Democratic leaders support the language included in the supplemental spending measure, adding, "The Medicare/Medicaid provision is expected to be in the House supplemental and was included in the Senate mark at the request of the Democratic leadership in the Senate with the support of the chair of the Senate Finance Committee."

Margaret McPhillips, a spokesperson for Cochran, said, "Senator Cochran was certainly not consulted about this issue. We hope the chairman will carefully consider Sen. Grassley's concerns," adding, "There are several pieces of the House and Senate drafts that don't belong on a supplemental appropriations bill, particularly if there is to be no opportunity for amendments on the House or Senate floor, and no conference committee" (CQ Today, 5/9).