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September 4, 2007


September 4, 2007


Congress Returns to Work - Lots of Unfinished Business

This week Congress returns to work after the August recess with a daunting agenda of major legislation pending - much of it in the field of health. While the House has completed action on all appropriations bill, the Senate has passed only one, making it highly likely Congress roll all the remaining appropriations bill into one omnibus bill.

Congress also faces the prospect of Medicare legislation. The House passed legislation that addressed the Medicare physician update for 2008 and 2009 in addition to expanding federal support for children's health insurance. The Senate passed more limited legislation that included children's health insurance only. It remains to be seen whether Congress will enact Medicare legislation this session of Congress.

Legislation granting the FDA authority to regulate tobacco products is another major piece of health legislation awaiting action. The Senate Health Education Labor and Pensions Committee passed the FDA bill earlier this summer. Parallel legislation is expected to be considered by the House this fall.

While these health related bills will consumed significant legislative energy, Congress also faces other non-health related legislation including Iraq troop deployment, Iraq military and reconstruction funding, domestic security and surveillance legislation and infrastructure funding. With so much unfinished business left before Congress, it is unlikely all this key issues will be address before Congress adjourns.

Despite the press of legislative business, there are a few bills of interest to the respiratory community that the ATS is encouraging Congress to address this session. Below are the key priorities the ATS will be advocating in the time remaining this Congressional session.


Physician Payment Fix

The ATS will continue its efforts with the rest of the physician and provider community to ensure Congress enact legislation to address the sustainable growth rate (SGR) which determines the annual Medicare physician payment update. Unless Congress acts, Medicare physician payment will be cut by 10% starting 2008 as a result of the flawed SGR formula. Further cuts are expected in subsequent years leading to an overall reduction of 40% in Medicare physician reimbursement over the next few years.

The ATS will continue to urge Congress to enact legislation the averts the projected cut in 2008 and permanently changes the underlying flawed SGR formula.

Pulmonary Rehabilitation

Senate Action on Pulmonary Rehabilitation

The ATS will continue its efforts to enact legislation creating a national coverage policy for pulmonary rehabilitation under Medicare. The bill now has 134 cosponsors in the House of Representatives and 33 cosponsors in the Senate. Despite this broad bipartisan support, the pulmonary rehabilitation legislation was not included in the House Medicare bill.

The ATS Washington Office staff is working closely with Senate supporters to ensure that the pulmonary rehabilitation provision will be part of the Senate's Medicare bill.


FDA Authority to Regulate Tobacco Products

As mentioned previously, the Senate HELP Committee passed a strong bill to give the FDA authority to regulate tobacco products. The bill now has 52 in the Senate, enough to guarantee final passage, but not enough to override an attempted filibuster. The ATS will be focusing its efforts bill additional support for the FDA bill and ensure no weakening amendments are adopted during the Senate floor consideration of the bill.


Global TB Bill Up for House Vote

The global tuberculosis (TB) control bill, the Stop TB Now Act, H.R. 1567, is set to be considered by the full House of Representatives following its unanimous passage by the House Foreign Affairs Committee, chaired by Rep. Lantos (D-CA), at the end of July. The bill, 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 resources through the U.S. Agency for International Development (USAID) and Centers for Disease Control (CDC) for the expansion of TB control programs, including directly-observed treatment therapy. The bill authorizes up to $400 million in funding for fiscal year 2008 and up to $550 million in fiscal year 2009. 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, chaired by Sen. Biden (D-DE), in September. The ATS Washington office will be working to ensure that the bill moves through the House and Senate as quickly as possible. ATS members and friends are urged to contact their House Representative now to request their cosponsorship and support for a House floor vote on H.R. 1567.

How to Take Action
Call the Capitol Switchboard at 1-202-224-3121 and ask for your Representative or give your zipcode if you do not know their name. When you are connected to an office, ask for the Foreign Affairs Legislative Assistant. If you leave a voicemail message, include your name and phone number so that they can call you back.

The following is a sample phone message: "I am a constituent and a healthcare provider from (your town) and I am calling to ask Rep. ___ to strengthen global tuberculosis control efforts and prevent outbreaks of drug-resistant TB by cosponsoring the Stop TB Now Act, H.R.1567, and pushing for a House floor vote on the bill as soon as possible."

Click on the following link for more information on contacting your Representative: http://www.thoracic.org/sections/about-ats/advocacy/take-action-now.html

Domestic TB Bill Under Senate Committee Consideration

The domestic TB control bill, the Comprehensive TB Elimination Act, S. 1551, will be considered by the Senate Health, Education, Labor and Pensions (HELP) Committee, chaired by Sen. Kennedy (D-MA), in September. The bill increases resources and funding for CDC's TB control activities, including state TB control programs, and expands research into TB diagnostics, drugs and vaccines. Action has not yet been scheduled on the House version of the bill, H.R. 1532, sponsored by Reps. Green (D-TX) and Wilson (R-NM). The ATS Washington Office will keep members informed of when their action is needed to support domestic TB control legislation.


Annual Health Funding Legislation to be Finalized

Beginning in September, the Senate will finalize work on the Fiscal Year 2008 Labor-Health and Human Services and Education (L-HHS-ED) Appropriations bill. This bill funds all health research and services and education programs for 2008. Before the Senate adjourned for the August recess, Senate Majority Leader Reid (D-NV) announced that the L-HHS-ED Appropriations bill will be considered by the full Senate as part of an omnibus appropriations package with other appropriations bills due to constraints in the Senate schedule before the chambers adjournment in late October.

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