	Introduction

Each year, the President is required to submit a comprehensive federal budget proposal to Congress no later than the first Monday in February. Once it is submitted, the Congressional Budget Office (CBO) analyzes the proposal using its own economic assumptions and estimation techniques. Then, the House and Senate Budget Committees each develop a budget resolution after reviewing the President's budget, the views of other committees, and information from CBO. Differences between the houses are supposed to be resolved by April 15, but this deadline is rarely met. Although it is not binding, the resolution provides a framework for subsequent legislative action on the budget (e.g., annual appropriations bills). It will be updated to reflect relevant activity until the President's FY2008 budget is released. Medicaid and SCHIP in the President's FY2007 Budget

The President's FY2007 budget contains a number of proposals that would affect Medicaid and SCHIP. Some are program expansions, and others are designed to reduce federal spending. Legislative Versus Administrative Proposals

As shown in Table 1 , some of the President's proposals would require legislative action, while others would be implemented administratively (e.g., via regulatory changes, issuance of program guidance, etc.). H.R. Reports. (pdf)

	Congressional Action

On March 9, 2006, the Senate Budget Committee reported a budget resolution, S.Con.Res. 83 , which was subsequently amended and passed by the Senate on March 16. The resolution did not include reconciliation instructions for the Senate Finance Committee, which has jurisdiction over Medicaid and SCHIP. It did include a deficit-neutral reserve fund for the uninsured, and a March 8 Senate Budget Committee document indicates that it included funding for four of the President's Medicaid and SCHIP proposals:
TMA extension ($523 million over five years); Vaccines for Children proposal allowing health departments to provide vaccines ($715 million); Cover the Kids initiative ($874 million); and SCHIP funding boost in 2007 and 2008 ($225 million). On March 29, 2006, the House Budget Committee reported its own budget resolution, H.Con.Res. 376 , which was subsequently amended and passed by the House on May 18. The resolution did not include reconciliation instructions for the House Energy and Commerce Committee, which has jurisdiction over Medicaid and SCHIP. 109-402 ) indicates that spending levels for Medicaid and SCHIP were based on CBO's baseline projections under current law and policies, and that no reduction in Medicaid was assumed. Although no agreement was reached by the House and Senate on a FY2007 budget resolution, current law spending for Medicaid and SCHIP is unaffected. As entitlement programs, their spending levels are based on the underlying benefit and eligibility criteria established in law (in the case of SCHIP, these criteria include a statutory annual funding cap). However, legislation that would increase Medicaid or SCHIP spending above current law could encounter procedural roadblocks in the House or Senate if funding is not assumed in a budget resolution or in a "deeming resolution." The annual appropriations process also provides an opportunity for Congress to place limitations on the availability of federal funds for specified Medicaid and SCHIP activities. Before the 109 th Congress adjourned, it passed two bills that addressed a variety of Medicaid and SCHIP issues, including some of the proposals in the President's FY2007 budget. H.R.
Each year, the President is required to submit a comprehensive federal budget proposal to Congress no later than the first Monday in February. Once it is submitted, the Congressional Budget Office (CBO) analyzes the proposal using its own economic assumptions and estimation techniques. Then, the House and Senate Budget Committees each develop a budget resolution after reviewing the President's budget, the views of other committees, and information from CBO. Differences between the houses are supposed to be resolved by April 15, but this deadline is rarely met. Although it is not binding, the resolution provides a framework for subsequent legislative action on the budget (e.g., annual appropriations bills).
The President's FY2007 budget contains a number of proposals that would affect Medicaid and the State Children's Health Insurance Program (SCHIP). Some are program expansions, and others are designed to reduce federal spending. While certain proposals would require legislative action, others would be implemented administratively (e.g., via regulatory changes, issuance of program guidance, etc.).
On March 9, 2006, the Senate Budget Committee reported a budget resolution, S.Con.Res. 83, which was subsequently amended and passed by the Senate on March 16. The resolution did not include reconciliation instructions for the Senate Finance Committee, which has jurisdiction over Medicaid and SCHIP. It did include a deficit-neutral reserve fund for the uninsured and funding for four of the President's Medicaid and SCHIP proposals.
On March 29, 2006, the House Budget Committee reported its own budget resolution, H.Con.Res. 376, which was subsequently amended and passed by the House on May 18. The resolution did not include reconciliation instructions for the House Energy and Commerce Committee, which has jurisdiction over Medicaid and SCHIP. Its spending levels for Medicaid and SCHIP are based on CBO's baseline projections under current law and policies, with no reduction in Medicaid assumed.
Although no agreement was reached by the House and Senate on a FY2007 budget resolution, current law spending for Medicaid and SCHIP is unaffected. As entitlement programs, their spending levels are based on the underlying benefit and eligibility criteria established in law (in the case of SCHIP, these criteria include a statutory annual funding cap). However, legislation that would increase Medicaid or SCHIP spending above current law could encounter procedural roadblocks in the House or Senate if funding is not assumed in a budget resolution or in a "deeming resolution." The annual appropriations process also provides an opportunity for Congress to place limitations on the availability of federal funds for specified Medicaid and SCHIP activities.
Before the 109th Congress adjourned, it passed two bills—H.R. 6111 and H.R. 6164—that addressed a variety of Medicaid and SCHIP issues, including some of the proposals in the President's FY2007 budget. This report will be updated to reflect relevant activity until the President's FY2008 budget is released.