Congress Passes Health Reform - President Obama Signs into Law

Following final passage by Congress, the President signed into law a major health care reform bill this week. The legislation will impact nearly every facet of the U.S. health care system. The law outlines broad health insurance system reforms, a mandate for individuals to have health insurance, cuts in Medicare reimbursements, simplification of administration, new measuring and reporting systems, strategic planning for physician/health care worker supply, grants specifically to address malpractice reform, funding for comparative effectiveness research, and cost containment provisions. The law aims to expand insurance coverage to 94 percent of Americans through creation of a health insurance exchange and subsidies for individuals to purchase insurance.

Congress also completed work on a budget reconciliation bill that made a number of corrections and revisions to the health reform legislation enacted earlier in the week. After a long series of votes in the Senate, the bill included minor Senate modifications and was returned to the House, which quickly passed the bill. The President is expected to sign it in the very near future.

While enactment of the legislation represents a legislative victory for President Obama and the Democratic Congress, it does not address a major concern of the physician community - a permanent fix to the sustainable growth rate (SGR) formula. Without Congressional intervention, the SGR formula will lead to a 22 percent cut in Medicare payments to physicians and other providers later this year. The good news is that Congress has already acted twice in 2010 to forestall the cuts. The bad news is that Congressional action only implemented temporary delays in the cuts. The ATS will continue to demand that Congress pass a permanent fix to the SGR formula.

While the ATS remains committed to ongoing advocacy to change the SGR formula, we must also look towards the future. Enactment of health reform is only the first step in the process of turning law into policy. Over the next several years, the federal government, largely through the Department of Health and Human Services and its agency the Centers for Medicare and Medicaid Services, will promulgate a series of proposed regulations aimed at implementing the new health legislation. The ATS and the physician community at large must play an active role in shaping these forthcoming regulations to ensure that our health care system evolves into a more efficient and effective system for both patients and providers.

RESEARCH

ATS Testifies for House Appropriations Committee

ATS member Dona Upson, MD testified before the House Military Construction and Veterans Affairs Appropriations Committee this week, calling on Congress to provide increase funding for the VA research program. Dr. Upson recommended that Congress provide $700 million for the VA Medical and Prosthetic Research Program and an additional $300 million in the VA minor construction budget to address the deteriorating conditions in the VA laboratory infrastructure.

CLEAN AIR

ATS Calls for Stricter Ozone Standard

The ATS submitted comments to the Environmental Protection Agency this week recommending EPA establish a stricter standard for ozone pollution of 0.060 ppm over an eight hour period. EPA is the process of reviewing its current standard of 0.075 ppm over an eight hour period, and is considering a new standard that would reduce it to between 0.070 and 0.060 ppm. In our comments, the ATS pointed out that existing research shows adverse health effects from ozone exposure are evident at levels below the current standard.

A final rule is expected from EPA later this year.

TUBERCULOSIS

ATS Convenes World TB Day Congressional Briefing

In honor of World TB Day on March 24, the ATS held a briefing in the House of Representatives that featured a very moving presentation by a young American man, Max Woodliff, who was infected with multi-drug resistant (MDR) tuberculosis while traveling in Central Asia in 2008. Rep. Eliot Engel (D-NY), congressional sponsor of the briefing, thanked Mr. Woodliff for his courage in coming to DC to speak publicly about his experience on the harsh MDR-TB regimen, and said his story points to the urgent need for new TB drugs. Mr. Woodliff, who compared some of the TB antibiotics to chemotherapy, echoed this point by directly appealing for more research on TB "so that fewer people have to go through what I have been through." The briefing panel was moderated by Phil Lobue, MD, from the CDC Division of TB Elimination, who gave an overview of new national data that shows a significant decline in TB in the U.S. The panel's other speakers included Diana Weil, Policy Coordinator for the World Health Organization, who gave an overview of the new WHO TB surveillance report, ATS member Randall Reves, MD, who presented the new Stop TB USA TB Elimination Plan, and Ann Ginsberg, Medical Officer with the TB Alliance, who discussed the organization's work developing new TB drugs, including the new Critical Path Initiative with the FDA and pharmaceutical companies.

MDR TB Survivor Max Woodliff meets Congressman Eliot Engel (D-NY), a longtime supporter of TB initiatives in the US House of Representatives

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