WASHINGTON – Prospects for passage of a robust healthcare IT bill appear dim as Congress faces cuts to Medicaid and Medicare spending and grapples with the cost of paying for the aftermath of Hurricane Katrina, congressional sources said Tuesday.

Rep. Patrick J. Kennedy (D-R.I.) said he expected any healthcare IT legislation coming out of Congress this year to be "very minimalist" in scope. Kennedy and Rep. Tim Murphy (R-Pa.) have both introduced a healthcare IT bill (H.R. 2234). A handful of other healthcare-IT related bills have been introduced in Congress this year.

On the Senate side, a bill from Sen. Michael Enzi (R-Wyo.) is still awaiting a vote on the Senate floor. The bill, called the Wired for Healthcare Quality Act, has 34 Senate sponsors. Rep. Kennedy said Senate Majority Leader Bill Frist (R-Tenn.) had been in talks with House Speaker Dennis Hastert (R-Ill.) about moving a healthcare IT bill.

Michael Zamore, a policy advisory for Rep. Patrick Kennedy, predicted that any healthcare IT bill that would pass is likely to be a "lowest common denominator bill" that would codify actions already under way within HHS and the Office of the National Coordinator for Health Information Technology, led by David Brailer, MD.

"There's still a decent chance of passing something this year, but the chance of passing something that can really move the levers is unlikely," Zamore told congressional staff Tuesday at a Capitol Hill event hosted by Perot Systems.

There is also a chance the White House's $125 million fiscal year 2006 budget request for Brailer's office and several prototypes to test a national health network for exchanging healthcare data won't be fully funded. House and Senate spending bills differ on the amount allocated for healthcare IT. Ann Woodbury, who formerly worked for the Center for Health Transformation, urged lawmakers to have the foresight to fully fund healthcare IT because of the estimated $81 billion to $121 billion in healthcare savings nationwide that could be gained from its use.

"We need to have more foresight and we need to invest in it now," said Woodbury, who currently works for Fleishman-Hillard's healthcare division.

Part of the problem, some experts maintain, is the way the Congressional Budget Office scores legislation. Former House Speaker Newt Gingrich, who leads the Center for Health Transformation, has long argued that federal scorers do not take into account the savings that would be gained through the use of IT in healthcare and only look at the immediate costs that a legislation would have on the federal budget.

"We do see it as a huge barrier to passage of significant legislation," said David Merritt, project director for health information technology at the Center for Health Transformation.

The Center for Health Transformation has been reaching out to analysts at CBO and members of Congress to change the system. Merritt said leaders in the House have committed to ask the CBO to consider a macroeconomic analysis of any healthcare IT bills that pass the House.

Recent events such as Hurricane Katrina and the potential outbreak of Avian bird flu or the threat of a bioterrorist attack should give healthcare IT issues the urgency they need, Woodbury said. Grassroots efforts from regional stakeholders and medical groups, such as the American Heart Association, are also are needed to get the attention of lawmakers.

"There's a lot of interest in healthcare IT. I don't know that there is a clear consensus about what should be done," Zamore said.