Tight budgets may constrain what the Democrats can do about health care in 2007.

Capitol Hill staffers gave that assessment here earlier this week during a briefing on health care sponsored by the Alliance for Health Reform, Washington.

House members, for example, included making health care more affordable on their “6 for 06″ campaign platform this fall, but financial concerns will affect efforts to take steps such as reducing or eliminating the Medicare Part D prescription drug plan “donut hole,” speakers said.

The donut hole is a gap in basic Part D benefits that affects plan members who exhaust everyday drug benefits and have not yet spent enough on covered prescriptions to qualify for catastrophic coverage.

This year, the donut hole stretches from $2,250 to $5,100.

The government covers donut hole expenses for the poorest plan members, and it pays 95% of the tab for expenditures over the $5,100 mark.

House leaders are serious about returning to the old “pay as you go” rules of the early 1990s, speakers said.

Under the old pay-go rules, lawmakers who wanted to cut taxes or increase spending had to offset the budget effects of those moves by increasing other taxes or cutting other types of spending.

Another change will involve procedures for developing bills.

In the past few years, committee leaders have posted the texts of some long, important bills just hours before lawmakers had to vote on the bills.

It’s still unclear how the health problems facing Sen. Timothy Johnson, D-S.D., will affect Senate leadership and Senate committee administration.

But, during the 110th Congress, Democrats on the Senate Finance Committee hope to act under “regular order,” meaning that they want to hold hearings before deciding what to do about health care legislation and other legislation, according to Kate Leone, a health policy advisor for Sen. Harry Reid, D-Nev.

Similarly, Rep. John Dingell, chairman-designate of the House Energy and Commerce panel, has made it clear he will consider all health care issues under “regular order” and, in general, act “under an open process,” said Bridgett Taylor, a member of the committee’s Democratic staff.