“There is a lot of confusion up there,” Jim Nussle, director of the Office of Management and Budget, said of Congress. “We are not sure how to deal with them.”

As a first step, Democrats this week chose to combine the nearly $151 billion measure that pays for a wide variety of health and labor programs — and which the president has threatened to veto — with a very popular $64 billion veterans measure that the president has said he will sign even though it exceeds his limit by $4 billion.

The health bill exceeds the president’s spending allotment by about $10 billion — almost half of the overall amount at issue. But some of those increases are designated for highly popular initiatives such as National Institutes of Health research and federally funded community health centers. Those centers, in line for an added $225 million to open new facilities and expand existing ones, have been hailed for delivering economical care to the nation’s uninsured, with President Bush calling them a “really good use of taxpayers money.”

Republicans have objected to merging the health and veterans measures and Senate Republicans said today that they would use a new procedural tool to try to split them, forcing Democrats to send Mr. Bush the health bill on its own.

“There is no reason to put the veterans and our active-duty military and all of their needs that would be met immediately into a bill that has nothing to do with this issue and which the president has given the signal he is going to veto,” said Senator Kay Bailey Hutchison, Republican of Texas.

Other Republicans say a focus on the overall $22 billion divide is misleading, because the increases, when extended over five years, would amount to $204 billion. “That throws off the effort to balance the budget and puts pressure on the need to raise taxes,” said Representative Paul D. Ryan, Republican of Wisconsin. Republicans also intend to highlight earmarks — the special projects added by lawmakers — to show the bills contain wasteful spending pushed by powerful patrons in Congress.

Democrats contend that Republicans spearheaded the expansion of earmarks when they controlled Congress and that such projects are sought by both sides. They point to a Congressional Research Service report that shows the Republican-led Congress regularly exceeded the Bush administration’s spending limits when emergency and war money was factored in and that the president never balked. And they note that Republicans routinely merged spending bills when they were in charge.