A handful of House Republican moderates are having second thoughts about their December vote to curb federal programs like Medicaid and student loan subsidies, adding at least some suspense to a revote on Wednesday.

Republican leaders remain confident they will prevail on the five-year, $39 billion budget-cut measure, the first bill in eight years to take on the spiraling growth of benefits programs whose budgets go up each year as if on autopilot.

The bill blends relatively modest cuts to Medicaid, Medicare and student loan subsidies with a renewal of the 1996 welfare reform bill and $10 billion in new revenues from auctioning television airwaves to wireless companies. There's also $1 billion in new spending to extend an income subsidy program for dairy farmers and a reprieve for physicians who face a 4 percent cut in their Medicare fees.

A virtually identical bill passed the House by a party-line 212-206 vote in the wee hours of Dec. 19 -- only a few hours after negotiations had wrapped up. The unusual timing of the vote made it virtually impossible for lawmakers to know every detail in the bill.

Several GOP moderates who had earlier opposed a more stringent version switched to vote "aye" since cuts to food stamps were dropped and curbs to the Medicaid program for the poor and disabled were eased. The bill now comes back to the House for an unusual revote because Senate Democrats forced technical changes that the House needs to accept before it can be sent to President Bush for his signature.

After the powerful AARP seniors lobby, student groups, pediatricians and others mounted a monthlong campaign in opposition to the bill, some lawmakers are re-examining their votes.

GOP Rep. Rob Simmons, who represents a predominantly Democratic district in Connecticut, announced last week that he would oppose the bill. Reps. Christopher Shays, R-Conn., John Sweeney, R-N.Y., Sherwood Boehlert, R-N.Y., Jim Gerlach, R-Pa., and Mike Fitzpatrick, R-Pa., said in interviews they have moved, to varying degrees, into the undecided camp. Shays and Gerlach, for instance, said they are leaning in favor of the bill.

AARP is opposed to a provision tightening Medicaid nursing home care rules regarding people who shed assets to qualify for such care. It argues that money given to charities, churches and family members within the previous five years could unfairly disqualify seniors from long-term care.

Pediatricians say provisions allowing states to eliminate some guaranteed Medicaid child health care services and charge new and increased co-payments end up hurting children. Their argument was bolstered by a new Congressional Budget Office study that predicts that much of the Medicaid savings would accrue because new co-payment requirements would drive tens of thousands of beneficiaries out of the program.

"We must not deny poor children medical care," said Eileen M. Ouellette, president of the American Academy of Pediatrics. "The very idea of it should anger citizens across the country."

A spokeswoman for Rep. Roy Blunt of Missouri, the acting majority leader and GOP whip, said he's "confident that the outcome of the budget vote will be successful."

The vote comes the day before an internal GOP election to replace Tom DeLay of Texas as the No. 2 Republican in the House. Blunt is the front-runner, but his chances to win the job could be damaged if the budget bill fails.

Even opponents of the bill seem resigned to its passing. And the fact that so many members are calling themselves undecided rather than switching to scuttle the measure suggests they might be seeking leverage to win future concessions.

For example, Boehlert and Sweeney are disappointed that the measure provides $1 billion in low-income heating subsidies, but only for next year instead of the current winter season.

The bill comes as Capitol Hill Republicans are trying to burnish their party's budget-cutting credentials amid increased concern about the rising deficit and the costs of the Iraq war and Hurricane Katrina.

Bush is eager to sign the bill and move on to next year's budget cycle. He releases his 2007 budget plan Feb. 6, which is likely to call for new cuts to benefits programs like farm subsidies, Medicaid, food stamps and Medicare, but many lawmakers and budget experts are skeptical of the chances for another budget-cut bill during an election year.