March 21, 2005

OXYGEN

ATS Comments on Air Travel with Supplemental Oxygen
In March, the ATS submitted comments to the Department of Transportation (DOT) regarding difficulties faced by patients who require supplemental oxygen during commercial flights. The ATS comments acknowledged DOT’s ongoing efforts to establish revised regulations that will improve travel access for patients who require supplemental oxygen. While acknowledging efforts in this area, the ATS also pointed about regulatory requirements that create significant cost and convenience barriers for patients seeking to use supplemental oxygen during air travel.

ATS expects that this spring the Federal Aviation Administration and DOT will issue regulatory policy that will significantly improve travel options for people who use supplemental oxygen.

CLEAN AIR

Bush’s Clear Skies Legislation Fails in the Senate
In March, by a vote of 9-9 the Senate Environment and Public Works Committee failed to pass President Bush’s Clear Skies proposal to significantly revise the Clean Air Act. Sen. Chaffee (R-RI) and Sen. Jeffords (I-VT) joined Democrats on the committee in opposing the proposal. The vote result is being heralded by the environmental community as a significant win for improving the air quality in the U.S.

The Bush Clear Skies proposal would have replaced existing facility specific emissions limits for an overall cap and trade system. Under a cap and trade system, facilities whose emission fall below limits could sell emissions credits to those facilities that exceed targets. Critics note that the Clear Skies proposal would allow pollution at levels that exceed current provisions of the Clean Air Act and would provide very little protection to people who live near facilities who are buying emissions credits.

In addition to concerns with the Clear Skies impact on existing pollutants regulated by the Clean Air Act, negotiations around the Clear Skies proposal were further complicated by whether carbon dioxide emissions should be regulated as a green house gas.

EPA Issues Clean Air Interstate Rule
Immediately after the failed vote on the Clean Skies proposal, the Environmental Protection Agency (EPA) issued a Clean Air Interstate Rule (CAIR) to control nitrogen oxide and sulfur dioxide emissions in the eastern U.S. The rule will cover 28 states and the District of Columbia and calls for a 70% reduction in sulfur dioxide emissions and 60% reduction in nitrogen oxide emissions by 2015.

SLEEP

IOM Announces Sleep Meeting
The Institute of Medicine announced the first in a series of public meetings to collect comment on explore the public health significance of sleep disorders in the U.S. The first meeting, April 11th and 12th in Washington D.C. will solicit input from invited experts on sleep disorders to identify pressing issues in the field of sleep disorders. Each speaker will also be asked to identify the three or four major outstanding questions that need to be answered, the barriers impeding these questions from being realized, and what can be done to overcome these barriers. There will be a brief time for public input during the meeting.

It is expected that the IOM will schedule additional meetings to collect public input.

TOBACCO CONTROL

FDA Tobacco Bill introduced in Congress
Last week Sen. Mike DeWine (R-OH) and Sen. Ted Kennedy (D-MA) and Rep. Jo Ann Davis (R-VA) and Rep. Henry Waxman (D-CA) introduced legislation to give the Food and Drug Administration (FDA) authority to regulate tobacco products. The American Thoracic Society has joined several other health groups in supporting the legislation.

The legislation is the same bill that was considered during the last Congress and was approved by the Senate by a vote of 78-15.

• The legislation would grant the FDA the authority to:
• Reinstate the 1996 FDA Rule on youth access and marketing, which among other things provided for federal enforcement and penalties against retailers who sell tobacco products to minors.
• Grant the FDA authority to restrict tobacco marketing to the maximum extent permitted by the First Amendment to the Constitution (this is the broadest possible authority the FDA could receive).
• Require detailed disclosure to the FDA of what is in each tobacco product by brand and by quantity in each brand, including all product constituents and smoke constituents.
• Grant the FDA authority to require changes in current and future tobacco products to protect public health, such as the reduction or elimination of harmful ingredients, additives and constituents, including smoke constituents.
• Srictly regulate health claims about tobacco products. Tobacco companies could not make any explicit or implicit health claims, such as reduced risk of disease or reduced exposure to specific toxins, without first proving to the FDA that the scientific evidence is adequate to conclude BOTH 1) that the product as actually used by consumers will significantly reduce the risk of disease to individual consumers AND 2) that the product as marketed will benefit the population as a whole.
• Ban terms such as ""light", "low" and "mild" that have misled consumers into believing some cigarettes are less hazardous than others.
• Require larger and more informative health warnings on tobacco products.
• Ban candy and fruit flavorings in cigarettes.
• Expand state authority over tobacco marketing. Currently, states have no right to regulate tobacco advertising. Under this legislation, states and localities could impose bans or restrictions on the time, place and manner, but not content, of the advertising and promotion of tobacco products.
• Preserve the right of state and local governments to adopt measures related to the sale, distribution, possession, exposure to, access to, and use of tobacco products, as well as fire safety standards for tobacco products. (Among other things, for example, states could increase the legal age of sale.)

ATS Join Amicus Brief in Tobacco Case
Last week, the ATS joined the American Medical Association, American Lung Association, the Campaign for Tobacco Free Kids and several other public health organization in an amicus curiae, or “friend of the court� in the Delaware State Court in the lawsuit in which Lorillard Tobacco Company is claiming that the American Legacy Foundation Legacy's “Truth� ads "vilify" the industry in violation of the Master Settlement Agreement. The states Master Settlement Agreement with the tobacco industry prevent the American Legacy Campaign from vilifying or personally attacking people or tobacco corporations.

As you may have seen, the Truth campaign includes imagines and statements that portray the tobacco industry as lying about the health effects of smoking and withholding information from the public. The tobacco industry is accusing the Truth campaign of violating the Master Settlement Agreement.

The brief urges the Delaware court to reject Lorillard’s claims. The amicus brief notes that the Truth ads have been successful in preventing youth tobacco use and are based on recommendations of experts in social marketing.

BUDGET

Medicaid cuts removed from Senate Budget resolution
On March 17, the House and Senate each passed their $2.7 trillion fiscal year 2006 (FY06) budget resolution. The resolutions each tried to trim the budget deficit. The House closely mirrored the president’s budget by cutting entitlement programs by $69 billion. However, in a move that will likely stall an agreement in Congress on the FY06 budget resolution, the Senate voted to pass a budget that does not closely mirror the president’s budget. The Senate budget would cut $15 billion from entitlement programs, including an estimated $13.9 billion from Medicaid -- over the next five years.

The removal of the Medicare cut from the Senate budget resolution was orchestrated by an amendment, introduced by Sen. Gordon Smith (R-OR) and Sen. Jeff Bingaman (D-NM). The amendment strikes all reconciliation instructions to the Senate Finance Committee, the committee with jurisdiction over Medicaid and Medicare, and instead calls for the creation of a bipartisan commission to study the impact of Medicaid reform proposals.

The ATS Washington Office will keep you abreast of the House and Senate conference committee negations.

Specter-Harkin Amendment for NIH Passes
Before the final passage of the fiscal year 2006 (FY06) budget resolution in the Senate, an amendment offered by Sen. Arlen Specter (R-PA) and Sen. Tom Harkin (D-IA) that would increase the National Institutes of Health (NIH) budget by $1.5 billion passed. The amendment was offered because in the president’s budget released in February, the NIH would receive a mere 0.5 % increase over FY05. During the floor debate, Sen. Specter said that the NIH budget offered by the president was "totally, totally, totally insufficient." The $1.5 billion added to the NIH by the Specter-Harkin amendment would be fully offset through a reduction in administrative expenses.

The ATS Advocacy network assisted in advocating for the passage of the amendment by sending over 50 letters to the Senate in support of the Specter-Harkin amendment. In addition, Dr. Sharon Rounds, ATS President sent a letter to the entire Senate in support of the amendment. In part, the letter stated that an increase in the NIH budget will ensure the number of scientists entering research will not be reduced because of inadequate funding. The President's budget, if enacted, will result in cuts in grant size which will reduce the number of young scientists working towards disease treatment and cures. The budget resolution proposed would fund approximately 402 less grants in FY06 than were funded in FY05.

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