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July 24, 2009

2009

July 24, 2009

House Energy and Commerce Bill Delays Continue

With the days dwindling before the August recess, House Energy and Commerce Committee Chairman Henry Waxman (D-CA) continues to meet with members of the "Blue Dog" coalition - a coalition of conservative Democrats - lead by Rep. Mike Ross (D-AR) to allay concerns over the cost of healthcare reform. The Blue Dogs hold seven votes on the Energy and Commerce Committee--enough votes, if combined with Republican opposition, to defeat the proposed healthcare reform bill.

The two sides appeared to reach a partial deal last week over cost control by adding a provision to the legislation that would give the Medicare Payment Advisory Commission (MedPAC) - a congressionally convened expert panel to provide policy related advice on Medicare issues - the authority to set Medicare provider reimbursement rates. The authority to set Medicare reimbursement rates currently rests with Congress.

While the MedPAC provision seemed to generate some interest in Congress and among the Blue Dog coalition membership, the provision was scored by the Congressional Budget Office - a non-partisan arm of Congress responsible for estimating the cost of legislation - as saving $2 billion over 10 years, far less than supporters had hoped.

Chairman Waxman is continuing to meet with Rep. Ross and other members of the Blue Dogs to try to reach a compromise. It is unclear if the committee will resume marking up the healthcare bill before the August recess.

Meanwhile, the Senate Finance Committee continues to hold discussions in an attempt to draft a bipartisan healthcare reform package. While there are a number of provisions being worked on by the Finance Committee, most of the bipartisan discussion centers around whether to offer and how to construct a public options and how to pay for healthcare reform. The Senate Finance Committee is not expected to consider healthcare reform legislation before the August recess.

Research: House Approves 2010 Health Spending Bill

On July 24, the House passed the FY 2010 health research and services spending bill, known as the Labor-HHS-Education Appropriations Bill. The House passed the bill by a margin of 264 to 153. The bill provides $30.966 billion for NIH, a 3.1 percent increase over FY 2009 and a 1 percent increase for the CDC.

The bill includes language requesting the CDC establish a program, including a public health action plan, on COPD, although funding has not yet been specified. The ATS is working with CDC's Office of Chronic Disease Prevention and members of Congress to ensure that a COPD public health program will be set up within the next year. The ATS was also successful in getting the following other agency directives included in the bill:

  • Directive applauding NHLBI's sleep research and calling for more study to modify the link between sleep disorders and cardiovascular disease.
  • Directive urging the NIAID to intensify research into new diagnostics, drugs and vaccines to halt the spread of drug-resistant TB.
  • Directive to CDC TB program grantees calling for minimal administrative costs to ensure adequate funding to all jurisdictions based on proportion and complexity of TB cases.

The House passed an amendment to the Labor-HHS bill offered by Rep. Issa (R-CA) to prohibit NIH from funding three peer-reviewed grants supported by the National Institute on Alcohol Abuse and Alcoholism (NIAAA) and the National Institute on Drug Abuse (NIDA). The grants are public health studies of behavioral factors involved in the transmission of HIV among sex workers and substance abuser populations in Thailand, China, and Russia. The ATS opposed this amendment in a letter to House Representatives on the basis of support for the NIH scientific peer-review process without interference from Congress.

The Senate Labor-HHS-Education Appropriations Subcommittee is scheduled to mark up its version of the health spending bill this week. It is not yet known if an amendment similar to the Issa measure will be offered in the Senate bill, which would be necessary for it to be enacted into law.

Below are tables of the funding levels for NIH institutes and CDC programs proposed under the Labor-HHS Appropriations Bill, which the House passed. The tables cover FY 2008 to proposed FY 2010.

National Institutes of Health (NIH) (in millions)

 

 PROGRAM

 

 

FY 08 ACTUAL

 

 

FY 09 ACTUAL

 

 

2010 HOUSE PROPOSED

 

 

+/-

 

NHLBI $2,922 $3,016 $3,106 +$90
NIAID $4,265 $4,416 $4,548 +$132
NIEHS $642 $662 $681 +$19.8
NINR $136 $141.8 $146 +$4.2
FIC $66.6 $68.6 $71.6 +$2
NCI $4,831 $4,969 $5,284 +$134
NIH TOTAL $29,229 $30,317 $31,259 +$941

Centers for Disease Control and Prevention (CDC) (in millions)

 

 PROGRAM

 

 

FY 08 ACTUAL

 

 

FY 09 ACTUAL

 

 

2010 HOUSE PROPOSED

 

 

+/-

 

DOMESTIC TB $140.3 $143.8 $144.2 +$0.398
ASTHMA $30 $30 $30.9 +$0.900
NIOSH $381 $360 $369 +$9
CHRONIC DISEASE $833 $882 $911 +$29
CDC TOTAL $6,430 $6,357 $6,424 +$67


Points of Contact

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