ALBANY, March 12 — Gov. Eliot Spitzer’s plan to cut health care spending is running into staunch resistance not so much from New York City Democrats but increasingly from the upstate and suburban Republicans who lead the State Senate.

The sides sharply escalated their attacks on Monday, with Mr. Spitzer, a Democrat, decrying the Senate’s proposed changes to his budget as “both profligate and pandering.”

A few hours later, the Senate took the unusual step of rejecting the health care part of the governor’s budget on a party-line vote, three weeks ahead of the budget deadline.

The Senate’s own budget proposals restore most of the $1.3 billion in state and federal health care spending the governor cut from his budget.

“This gets to be a moment of truth,” said the Senate majority leader, Joseph L. Bruno, the state’s top Republican. “Take a look at the cuts in the hospitals in your districts, take a look at the cuts in the nursing homes in your districts.”

He said: “That’s not reform. That’s pain.”

The day’s events brought into focus the emerging political calculus in Albany.

The governor is building on his reputation as a man who will criticize both Republicans and Democrats to upend what he considers the entrenched status quo. But his plan to overhaul the state’s Medicaid system has run into opposition from powerful interest groups and many influential Democrats in Albany and Washington, including Representative Charles B. Rangel.

The Republicans, reeling since Democratic victories in November’s election, have been aggressively allying themselves with hospital groups while also linking the governor’s budget to proposals by the Bush administration to cut federal health care spending.

In the middle is Assembly Speaker Sheldon Silver, who for years feuded with Gov. George E. Pataki and now seems eager to get along with Governor Spitzer. Mr. Silver, a Democrat, has also been working to persuade the governor and the health care lobby to stand down in an increasingly bitter media campaign against each other.

Over the last few days, the two houses released their budget proposals. The State Assembly increased Mr. Spitzer’s $120.6 billion to more than $121.2 billion.

“I applaud them for what they have done,” said the governor, in a change of tone from some of his earlier denunciations of Assembly Democrats. “While I do not agree with every element of their budget, they certainly have passed a budget that permits us to begin a discussion.”

Senate Republicans said that even after adding roughly $1 billion in new spending, their proposal did not increase Mr. Spitzer’s $120.6 billion budget. They accomplished that by not counting property tax rebate checks as spending, said John McArdle, a spokesman for Mr. Bruno. The Senate’s plan would triple property tax rebates to $2.6 billion; if that figure was added to the budget, overall spending would increase to more than $123 billion.

Edmund J. McMahon, the director of the Empire Center for Public Policy, a conservative policy group, said that not counting property tax rebates as spending was “like saying any kind of transfer payment is a tax cut.”

“It’s like saying a Medicaid reimbursement is a tax cut,” Mr. McMahon said. “It’s simply not so.”

Mr. McMahon said of the Legislature, “No matter how much you increase the budget, they’ll always increase it more.”

Among its changes to Mr. Spitzer’s budget, the Assembly proposed commissions to review potential pay increases for legislators and judges. Both chambers restored some of the municipal aid cuts made to New York City, which Mayor Michael R. Bloomberg had criticized.

The Assembly proposed restoring $483 million in state health care cuts; the Senate proposed to restore more than that, though the total was unclear. The Senate’s property tax relief plan would return $2.4 billion to property owners, instead of the $1.5 billion Mr. Spitzer proposed, and it would not exclude the wealthy; the governor’s plan is aimed at the middle class.

The Senate added $358 million in new school aid on top of substantial increases planned by the governor, and it tweaked his formula for distributing the aid to school districts.

The Senate budget also rejects money for 21 new state workers to oversee compliance with campaign finance regulations and cuts financing for Project Sunlight, a plan by Attorney General Andrew M. Cuomo to build a public database to track the activity of lobbyists, donors, elected officials and special interests.

If nothing else, the groundwork has been laid for the budget battle to come. On the Senate floor Monday, the deputy majority leader, Dean G. Skelos, a Long Island Republican, said, “If this happened last year, many of you who were here in the past would be wringing your hands in anguish that Governor Pataki had proposed such dramatic cuts to the health care industry.”

Darren Dopp, chief spokesman for Mr. Spitzer, said, “Republicanism in New York no longer involves even the pretense of fiscal restraint.”

Read article here