The House this week is expected to vote on an omnibus budget package totaling more than $500 billion. It encompasses 11 fiscal year 2008 appropriations bills, including healthcare provisions.

The package would mandate a 14% increase in spending for healthcare for veterans, but outlays for labor, healthcare and education programs may be frozen at 2007 levels. Discretionary spending could exceed about $4 billion more than President Bush called for. While Bush has said he would veto any package that exceeds his limits, he may be willing to compromise, reports say.

Meanwhile, the Senate could craft slimmed-down Medicare legislation before the winter recess next week. The purpose would be to stop a scheduled 10% reduction in Medicare physician fees that are set to take effect on Jan. 1. It also could contain an extension to the State Children’s Health Insurance Program. The bill could leave a few funding initiatives for skilled nursing facilities hanging in the balance, such as pending therapy caps. Also unknown is whether Congress will cut into a SNF Medicare payment increase to pay for other programs.