It’s not often that a powerful committee in the House unanimously approves legislation that President Bush opposes strongly.

But that’s what happened last week when the Energy and Commerce Committee cleared a bill, 46-0, that would block Medicaid regulations aimed at cutting the program’s costs. Initially, there was concern among panel Republicans about the measure, but committee Chairman John Dingell (D-Mich.) tweaked it and attracted GOP support.

The nation’s governors have lauded the House bill, which would halt seven proposed regulations issued by the Centers for Medicare and Medicaid Services (CMS).

Yet Senate Finance Committee ranking member Chuck Grassley (R-Iowa) has criticized the legislation and is attempting to rally enough GOP lawmakers to thwart the measure and sustain a presidential veto if necessary.

He faces an uphill battle. Regardless of the merits of the CMS regulations, senators are unlikely, especially in an election year, to embrace cost-cutting regulations that governors want torpedoed.
Senate Minority Leader Mitch McConnell (R-Ky.), who is being targeted by Democrats this November, has not tipped his hand.

During a floor speech last Wednesday, Grassley said he doesn’t think the regulations are perfect but added Medicaid has “a checkered history of financial challenges” and people who call themselves fiscal conservatives should practice what they preach by opposing the House bill.

Grassley added that the House “is trying to kick this can down the road to next year” and hoping the next president scraps the rules.

This is the second time Grassley will be going against his party on a major healthcare issue during the 110th Congress. He was one of only 18 Senate Republicans who backed the reauthorization of the State Children’s Health Insurance Program (SCHIP) that Bush vetoed. His persistence on SCHIP did not sit well with some Republicans in the upper chamber.

Grassley has bucked the president and some of his GOP colleagues on the economic stimulus package as well as energy tax legislation. He also ruffled the White House with his aggressive oversight when he chaired the Senate Finance Committee.

Now Grassley is going to bat for the White House, as he did on Bush’s tax cut packages and Medicare prescription drug bill.

Those measures had enough support to get to the president’s desk. But the chances of stopping the House measure getting to Bush’s desk look vanishingly small. Securing enough votes to sustain the White House’s promised veto also appears unlikely.