“This was a close call in the Senate, and a close call for me and many of my colleagues,” said Sen. Orrin Hatch.

Hatch said he preferred the version of the bill the Senate passed in November, but the compromise with the House was needed “to curb the unsustainable growth in entitlement spending.”

That meant tough choices, Hatch said. Before deciding to vote for the bill he said he spoke Tuesday night with Heath and Human Services Secretary Mike Leavitt, the former Utah governor, about his concerns.

“Secretary Leavitt assured me that he believes the budget bill will not hurt our more vulnerable citizens,” Hatch said. “He is going to maintain a watchful eye over implementation of this law to make sure that all Utahns' interests are protected.”

Sen. Bob Bennett said that in a budget of $2.5 trillion, two-thirds of it is “on autopilot,” because it is committed to entitlement programs, like Medicaid. He said Medicaid is projected to increase by 41 percent over the next five years, and the bill that the Senate passed Wednesday would limit the five-year growth to 39 percent.

“If we try to get fiscal discipline back entirely with discretionary spending we won't get there - we can't get there,” said Bennett. “This budget is not cutting back on Medicaid in the way most people understand cutting back.”

Karen Crompton, executive director of Voices for Utah Children, said the changes would cost the state about $3.7 million annually in Temporary Assistance for Needy Families funds, the nation's primary welfare program.

“When people say they want to reduce the deficit it's a little hard to believe when as soon as they get back [next year] they're going to push through $70 billion in tax cuts,” she said. That is more than $30 billion more than the savings in the bill the Senate approved Wednesday. “Who are we asking to pay for the tax cuts? The most vulnerable population out there,” Crompton said.

The bill also contains a provision that would exempt older missionaries, such as seniors serving as Mormon mission presidents, from having to pay Medicare premiums while they are serving overseas.

Since Medicare wouldn't cover missionaries overseas, they would have to have private coverage, as well, and the provision means they won't have to pay two premiums and will avoid a penalty when they return home and re-enroll in Medicare.