WASHINGTON - The House voted yesterday to block the Bush administration from cutting federal spending on Medicaid health care for the poor by $13 billion over the next five years.

President Bush has threatened a veto, but supporters have more than enough votes in the House to override him, and maybe in the Senate, too.

Two-thirds of the Republicans joined every voting Democrat in the 349-62 vote to impose a one-year moratorium, through next March, on seven rules changes the administration argues are needed to rectify waste and abuse in the state-federal partnership to provide health care to the poor.

Supporters of the bill said the rules would merely shift financial burdens to the states at a time of economic distress while reducing access to health care for the country's neediest people.

The governors of all 50 states, state Medicaid directors, and others oppose the rules, Energy and Commerce Committee Chairman John D. Dingell (D., Mich.) told the House. "They know the devastating effects these rules would have on local communities, upon hospitals, and upon vulnerable beneficiaries."

But first ...

The House vote margin was well above the two-thirds needed to override a presidential veto. Congress has overridden a Bush veto only once, in November on a water-projects bill.

But the legislation must first move through the Senate Finance Committee and get a vote on the Senate floor. Finance Committee Chairman Max Baucus (D., Mont.) applauded the House vote, saying he intended to work with his Senate colleagues "on strategies to stop harmful Medicaid regulations as well."

But his Republican counterpart, Charles E. Grassley of Iowa, has voiced opposition to the House approach of freezing the seven rules.

The Bush administration instituted the rules with the aim of saving the Treasury about $13 billion over five years and $33 billion over 10 years in programs that provide health coverage and nursing-home care to the poor.

'Already ... effective'

The White House, in a statement Tuesday warning of a veto threat, said the House bill would "thwart these efforts of the federal government to regain fiscal accountability and integrity in Medicaid."

But the proposed changes have met opposition from states, health-care providers, and advocates for the poor who say they will shift costs from the federal government to states and create new hardships for the needy.

"Some of these regulations already have become effective and current state estimates of the impact could be as high as four times the administration's $13 billion estimate," National Governors Association chairman Tim Pawlenty (R., Minn.) and other governors wrote lawmakers this month. Timely action to impose the one-year moratorium was "critical to avert significant disruptions in coverage for vulnerable populations," they wrote.

The proposed rules would affect programs involving payment to public safety-net institutions, rehabilitation services for people with disabilities, coverage of hospital clinical services, graduate medical-education payments, and specialized medical transportation to school for children covered by Medicaid.

Vote Is Set on DNA-Bias Bill

Lawmakers have agreed

to make it illegal for employers and insurance companies to deny applicants jobs and health-care coverage because DNA tests show they are genetically disposed to a disease.

The Senate plans to vote

today on the Genetic Information Nondiscrimination Act, and the House is likely to give

quick approval. President Bush has indicated his support.

The legislation forbids

sponsors of health coverage from requesting or using genetic information to adjust premiums

or determine eligibility.

It prohibits employers

from using genetic information in hiring, firing, assignment

or promotion decisions.

It also makes clear

insurance companies still have the right to base coverage and pricing on the presence of a disease.

The Senate unanimously passed versions in 2003 and 2005 but the House did not take up the issue until last year, when Democrats took over both chambers.

- Associated Press

How They Voted

Representatives from the Philadelphia area who voted in favor of delaying rules affecting Medicaid were Robert A. Brady (D., Pa.), Michael N. Castle (R., Del.), Charles W. Dent (R., Pa.) Chaka Fattah (D., Pa.), Jim Gerlach (R., Pa.), Tim Holden (D., Pa.), Frank A. LoBiondo (R., N.J.), Patrick Murphy (D., Pa.), H. James Saxton (R., N.J.), Allyson Y. Schwartz (D., Pa.), Joe Sestak (D., Pa.), and Christopher H. Smith (R., N.J.).

Voting against the delay was Joseph R. Pitts (R., Pa.).

Not voting was Robert E. Andrews (D., N.J.).