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August 3, 2007

2007

August 3, 2007

Headline

Senate Committee Passes FDA Tobacco Bill

The Senate Health Education Labor and Pensions (HELP) Committee passed legislation that would, for the first time, give the Food and Drug Administration (FDA) authority to regulate tobacco products. Enactment of this legislation is high priority for the respiratory health and broader public health community. During committee action, a number of amendments were considered, including the following amendments that strengthened the legislation:

  • Prohibition on tobacco manufacturers from claiming that any tobacco product has been approved or certified by the FDA.
  • Increase user fees paid by the tobacco companies to ensure that FDA has the necessary resources to effectively regulate tobacco products.
  • Require larger, stronger warning labels that cover half the front and back of cigarette packs. The warnings will be text initially, but within two years, the FDA must develop and require graphic warnings.
  • Clarify that the FDA has the authority either to increase or decrease nicotine levels in any type of tobacco products in order to promote public health.
  • Immediate ban on the use of clove as a cigarette flavoring.

The Committee also rejected a series of weakening amendments by Sen. Richard Burr (R-NC), including one that would have given the tobacco industry a vote on the Tobacco Products scientific Advisory Board that advises the FDA.

Attention now shifts to the full Senate where supporters of the legislation are trying to secure the 60 votes needed to ensure that the FDA bill is not defeated by a filibuster. Currently the bill has 53 cosponsors. An additional 7 votes are needed to ensure that the legislation is allowed to move forward in the Senate.

Parallel legislation has also been introduced in the House and currently has 193 cosponsors, just short of the number needed to ensure passage in the House.

Medicare

House and Senate Pass Children Health Insurance Expansion – Tobacco Tax Increases

This week the House and Senate passed separate legislation to extend and expand the State Children’s Health Insurance Program (SCHIP), a joint state-federal program designed to provide health insurance for children in families near or just of above the federal poverty level.

The more expansive House bill would extend health insurance to an additional 3 million children and cost $47 billion over 5 years. The House bill also fixes the Medicare physician fee update – which averts the predicted 10% cut in Medicare reimbursements to physicians in 2008 and further cuts in subsequent years. The House bill is paid for by a $0.45 federal tobacco tax increase and cuts to the Medicare program. Key among the House Medicare cuts is the proposal to reduce Medicare rental payments for oxygen from 36 months to 18 months. The original provision called for capped Medicare rental payments for oxygen at 13 months, but the cuts was scaled back during negotiations on by measure.

In a disappointing move, the House bill did not include a provision to create a national coverage policy for pulmonary rehabilitation.

The Senate bill would expand the SCHIP program to 3 million children and costs an estimated $35 billion over 5 years. The Senate bill includes a $0.61 tobacco tax increase. Unlike the House bill, the Senate bill does not contain any Medicare provisions.

After the August recess, the House and Senate will convene a conference committee to resolve the differences in the two bills. The ATS will continue to advocate for inclusion of the pulmonary rehabilitation provision during conference committee negotiations.

Tuberculosis

House Committee Passes Global TB Bill

In a victory for global tuberculosis (TB) control, the House Foreign Affairs Committee unanimously passed the global TB bill, the Stop TB Now Act, H.R. 1567, without amendments. There was concern that some Republican Committee members intended to speak against the bill due to concerns over the funding level in the legislation, but after questions on this issue were answered by the bill’s sponsor, Rep. Eliot Engel (D-NY) and the committee’s ranking Republican member, Rep. Ileana Ros-Lehtinen (R-FL), spoke in support of it, the bill quickly proceeded to an affirmative voice vote.

The Stop TB Now Act, HR 1567, sponsored by Reps. Engel (D-NY) and Wilson (R-NM), commits the US to the World Health Organization (WHO) goals of reducing the global TB deaths and disease burden by increasing funding and resources through the U.S. Agency for International Development (USAID) and Centers for Disease Control (CDC) for the expansion of TB control programs, including expanding directly-observed treatment therapy and strengthening health systems. The bill authorizes up to $400 million in funding for fiscal year 2008 and up to $550 million in fiscal year 2009.

The next step for the Stop TB Now Act is a floor vote in the House of Representatives in September when the chamber returns from its summer recess. The Senate version of the bill, S. 968, sponsored by Sens. Boxer (D-CA) and Smith (R-OR), is expected to be considered by the Senate Foreign Relations Committee in early September. The ATS Washington office will be working to ensure that the bill progress through the House and Senate as quickly as possible and will keep members informed of when their action is needed to support the bills.

Research

Senate to Consider Annual Health Funding as Part of Omnibus Bill

Senate Majority Leader Reid (D-NV) announced this week that he will not schedule the annual health research and services spending bill, the Labor-Health and Human Services and Education Appropriations bill (L-HHS) for a Senate floor vote in September because supplemental funding bills and other matters related to the Iraq war will not leave enough time for consideration of the bill and because the President has threatened to veto it. Instead, the Labor-HHS bill, as passed by the Senate Appropriations Committee, will be wrapped into either an omnibus appropriations bill or a smaller package that includes two or three other appropriations bills.

The House passed its FY 2008 Labor-HHS Appropriations bill on July 19. Included in it is a 2.6% funding increase for the National Institutes of Health (NIH), although the actual increase for NIH is less (1.9%) when the $201 million transfer of funds from NIH to the global AIDS fund is factored in. The Senate Appropriations Committee bill would provide a slightly larger increase of 3.3% for NIH, with the same amount subtracted for global AIDS. The Centers for Disease Control and Prevention (CDC) also fares slightly better under the Senate bill, where it receives a 4.3% increase over the 4.0% increase in the House Labor-HHS bill.



Points of Contact

Gary Ewart Senior Director, Government Relations
Nuala Moore Senior Legislative Representative
Joe Kirby DC Office Administrator