Washington Highlights: October 28,
2005
Contents
Prior Issues
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Senate Passes HHS Funding Bill, Adds Funding for
Pandemic Flu
The Senate Oct. 27 approved, 94-3, its version of the FY 2006 Labor-HHS-Education
appropriations bill (H.R.
3010), after accepting an amendment to add approximately $8
billion in emergency funding to help respond to a potential avian
flu outbreak.
The bill, which provides $141.7 billion in discretionary funds
for the departments of Labor, Health and Human Services, and Education
as well as related agencies, is the last of the FY 2006 spending
bills to come to the Senate floor. It now moves to the conference
committee to be reconciled with the bill passed by the House June
24 [see Washington Highlights,
June 24].
As expected, the Senate rejected a number of amendments offered
to add funds to a variety of health and educational programs. Many
of the amendments included no spending offsets and thus required
60 votes to waive budget points of order for exceeding the bill's
spending cap.
Sen. Tom Harkin (D-Iowa) offered the avian flu amendment, adopted
by voice vote, which provides nearly $8 billion to increase international
surveillance of avian flu outbreaks, to enhance the vaccine production
infrastructure in the United States, to build stockpiles of vaccines
and antiviral medications, and to strengthen the public health infrastructure
at the federal, State, and local levels. The funding was designated
as emergency spending, which means it did not need to be offset
and does not count against the bill's discretionary spending cap.
The Senate adopted by voice vote an amendment by Sen. John Sununu
(R-N.H.) to increase funding for community health centers by $50
million above the Appropriations Committee's recommendation of $1.839
billion. The amendment was offset by reducing the facilities construction
funds under the Health Resources and Services Administration, the
account used to fund Members' earmarks.
The Senate adopted by voice vote an amendment by Sen. Richard Durbin
(D-Ill.) to prevent candidates for appointment to federal scientific
advisory committees from being asked to disclose their political
affiliation or voting history or their positions on political issues
not directly related to and necessary for the work of the committee
involved. The amendment also prevents funding from the bill to be
used "to disseminate scientific information that is deliberately
false or misleading."
The Senate also adopted by voice vote an amendment by Sen. Patrick
Leahy (D-Vt.) to prohibit the use of federal funds to provide abstinence
education that includes information that is "medically inaccurate,"
which is defined as "information that is unsupported or contradicted
by peer-reviewed research by leading medical, psychological, psychiatric,
and public health publications, organizations and agencies."
In addition, the Senate adopted amendments to increase funding
for suicide prevention activities, for the HHS Office of Minority
Health and sickle cell disease, and for telehealth programs. Other
approved amendments direct the Department of Health and Human Services
to purchase no less than 1 million rapid oral HIV tests and direct
the Health Resources and Services Administration to provide $5 million
for programs to address dental workforce needs.
The Senate voted, 14-85, to reject an amendment by Sen. Tom Coburn
(R-Okla.) to transfer $60 million from the CDC's construction budget
to the AIDS drug resistance program.
The Senate defeated, 46-53, a proposal by Senate Budget Chair Judd
Gregg (R-N.H.) to increase funding for the Low Income Home Energy
Assistance Program (LIHEAP) by $1.3 billion, paid for by an across-the-board
cut of 0.9 percent of all discretionary programs in the bill.
The Senate Appropriations Committee approved H.R. 3010 on July
14 [see Washington Highlights,
July 15]. The committee-approved bill includes $29.415 billion
for NIH, an increase of $1.050 billion (3.7 percent) over the FY
2005 appropriation and $908 million over the House bill. The Senate
bill includes $298.7 million for Title VII health professions, an
$820,000 (0.3 percent) decrease from FY 2005. Most Title VII programs
were restored to their FY 2005 funding levels. Primary care medicine
and dentistry received a $1.2 million (1.3 percent) increase to
$90 million, and geriatric programs were cut by $2 million (6.3
percent) to $29.5 million. The House-passed bill provides just $47
million for two Title VII programs: $12 million for Centers of Excellence
and $35 million for Scholarships for Disadvantaged Students, an
84 percent cut below the current funding level for Title VII.
Information:
Dave Moore, Senior Director
AAMC Government Relations
dbmoore@aamc.org
(202) 828-0525
Senate Committees Pass Budget Reconciliation Bills
The Senate Budget Committee Oct. 26 approved, 12-10, a draft budget
reconciliation bill saving a net $39.1 billion from mandatory spending
programs over 5 years, exceeding the $34.7 billion target set in
the FY 2006 Budget Resolution (H.Con.Res. 95). The bill includes
$10 billion in net savings over 5 years from the Medicare and Medicaid
programs, as passed Oct. 25 by the Senate Finance Committee. Senate
leaders plan to bring the filibuster-proof package to the floor
for 20 hours of debate starting Oct. 31, with a final vote expected
Nov. 3.
Specific to Medicare and Medicaid, the bill nets $5.7 billion in
Medicare cuts over 5 years through reductions of $18.6 billion and
increases of $12.9 billion in Medicare spending. The bill also nets
$4.3 billion in Medicaid reductions over 5 years through $8 billion
in cuts and $3.7 billion in spending increases.
The bill includes a number of Medicare spending proposals
that would benefit hospitals and physicians such as a 1 percent
update to Medicare physician payments in 2006, a permanent moratorium
on limited service hospitals, and a delay on the "75 percent
rehab" rule. While the majority of the Medicaid savings proposals
do not directly impact hospitals and physicians, half of the Medicare
savings are attributed to the implementation of a Medicare value-based
purchasing program for providers. For information on additional
Medicare and Medicaid provisions [see Washington
Highlights, Oct. 21].
The Senate Finance Committee approved its reconciliation package
Oct. 25 by a party line vote of 11-9. In his opening remarks, Finance
Committee Chair Charles Grassley (R-Iowa) referenced the package
as a "carefully crafted compromise." Conservative Republican
members remarked that they were disappointed that the package spent
too much, did not include "real Medicaid reform," and
cut too much from Medicare Advantage. Democrats offered, without
success, several amendments primarily related to providing additional
relief to states and providers serving Katrina victims. All voted-upon
amendments failed along party lines. Republicans offered very few
amendments, which they subsequently withdrew.
Information:
Lynne Davis Boyle, Assistant Vice President
AAMC Government Relations
ldavisboyle@aamc.org
(202) 828-0526
House Committees Mark Up Budget Reconciliation
Bills
As required under the FY 2006 Budget Resolution agreement, the
House Energy and Commerce Committee passed (28-22) a budget reconciliation
package on October 27. Under the FY 2006 Budget Resolution agreement,
the Committee was to identify $14.7 billion in savings from programs
under their jurisdiction, including Medicaid. Because House Republicans
were seeking to offset the cost of hurricane relief, the savings
in the Committee's reconciliation package were expected to exceed
the initial target.
According to materials released in advance of the mark-up,
the Medicaid portion of the Committee's reconciliation package was
expected to reduce spending by $11 billion over five years. Among
the recommended savings were: prescription drug reimbursement reforms
($3 billion over five years); increased state flexibility in determining
benefit packages ($2 billion over five years) and co-pays ($2 billion
over five years) for certain beneficiaries and services; and restrictions
on asset transfers related to long-term care benefits ($2 billion
over five years). The Commerce Committee draft also included $2.5
billion in new funding for states who cared for Medicaid beneficiaries
affected by Hurricane Katrina.
The House Ways and Means Committee did not include Medicare or
Medicaid provisions in its final budget reconciliation legislation,
which was approved (22-17) on October 26. The Ways and Means package
achieves a net savings of $8 billion over five years by repealing
subsidies for companies affected by illegal foreign trade practices
($3.2 billion over five years), as well as by reducing funds for
child support, foster care and adoption assistance, Supplemental
Security Income (SSI), and other welfare programs. During debate
over the legislation, Reps. Pete Stark (D-Calif.) and Ben Cardin
(D-Md.) offered an amendment that would have temporarily averted
the scheduled reduction in Medicare physician payments by establishing
a temporary one percent update in Calendar Year 2006. The amendment
was ruled "non germane" because it also addressed Part
B premiums (it prohibited any premium increases that might result
from the temporary payment update), which are not under the Committee's
jurisdiction.
The two bills are expected to be included in the House Budget Committee's
reconciliation package, which is scheduled for mark-up during the
week of October 31.
Information:
Christiane Mitchell, Senior Legislative Analyst
AAMC Government Relations
cmitchell@aamc.org
(202) 828-0526
House Education Committee Approves Reconciliation
Bill
The House Committee on Education and the Workforce met Oct. 26
and 27 to approve a reconciliation package with $14.5 billion in
savings over 5 years. The draft bill, which included many of the
student financial aid proposals of the House Higher Education Act
(HEA) reauthorization bill (H.R.
609), passed on a party line vote, 22-17.
Like H.R. 609, the majority of the Committee's savings come from
reducing subsidies to private lenders and student-loan-guarantee
agencies. The bill also keeps the current interest rate cap on federal
Stafford loans (8.25 percent) and provides for a one-time fixed
or variable rate option on consolidation loans. Additional savings
would come from changes to origination fees on Stafford and consolidation
loans, including a 1 percent fee for graduates who consolidate their
loans.
During the full-day markup, a Democratic substitute offered by
Rep. George Miller (D-Calif.) to recycle the savings into the Pell
Grant program and lower the interest rate cap to 6.8 percent failed
20-27
Four additional amendments failed on party line votes of 22-17:
- a proposal by Rep. Chris Van Hollen (D- Md.) to eliminate the
1 percent fee that borrowers would have to pay to guarantee agencies;
- a proposal by Rep. Susan A. Davis (D-Calif.) freeze origination
fees in the direct-loan program at 1.5 percent through 2010. The
Republican-proposed reduction would not be fully phased in until
then, and the budget reconciliation bill would also eliminate
a discount that currently makes the 1.5 percent rate available;
- a proposal by Reps. Timothy Bishop (D-N.Y.) and Rush Holt (D-N.J.)
to provide a rebate to students whose aid was cut under recent
revisions to a federal formula for determining how much a family
can afford to contribute to a student's college costs;
- a proposal by Rep. Thomas E. Petri (R-Wis.) to reward colleges
that entered the direct-lending program with extra federal financial-aid
dollars for their low-income students.
The only amendment approved was offered by Rep. Vernon J. Ehlers
(R-Mich.) to require the National Academy of Sciences to conduct
a study of the quality of distance education, passed by a voice
vote.
However, H.R. 609 was not attached in its entirety to the reconciliation
draft bill. The Senate Oct. 18 attached their entire Higher Education
Act reauthorization bill (S.1614)
to the reconciliation bill they reported to the Senate Budget Committee
[see Washington Highlights, Oct.
21]. The Senate Budget Committee approved the "Deficit
Reduction Omnibus Reconciliation Act of 2005" Oct. 26.
Information:
Matthew Shick, Senior Legislative Analyst
AAMC Government Relations
mshick@aamc.org
(202) 862-6116
Animal Dealer Amendment Dropped; Hearing Examines
Radical Animal Rights Organizations
House and Senate conferees removed from the FY 2006 Agriculture
Appropriations bill (H.R.
2744) an amendment sponsored by Sen. Daniel Akaka (D-Hawaii)
that would have barred funding to research institutions that use
Class B animal dealers. Conferees Oct. 26 approved the compromise
bill, readying it for its expected approval by the House and Senate.
Class B dealers sell animals that have not been bred first-hand.
The AAMC Sept. 29 sent a letter opposing the amendment to conferees,
stating it would harm biomedical research at AAMC institutions [see
Washington Highlights,
Sept. 30].
Senate Committee on Environment and Public Works Chair James Inhofe
(R-Okla.) convened a hearing Oct. 26 to examine the terror campaigns
by radical animal rights organizations against individuals and companies
that support the use animals in biomedical research. The
witnesses discussed the structure and strategy of the animal
rights movement and described various incidents of harassment affecting
their families. Also testifying was Jerry Vlasak, M.D., a spokesperson
for Stop Huntington Animal Cruelty (SHAC), one of the more aggressive
animal rights organizations. Sen. Inhofe introduced Oct. 27 a bill
(S. 1926) that would amend current criminal law to allow federal
officials to prosecute organizations for threats and acts of force
or violence against animal enterprises.
Information:
Erica Froyd, Director, Public Health and Research Legislative Affairs
AAMC Government Relations
efroyd@aamc.org
(202) 828-0525
USDA Inspector General Issues Audit Report on
APHIS Animal Care Program
The Inspector General (IG) of the U.S. Department of Agriculture
has issued an audit report
on the Animal and Plant Health Inspection Service (APHIS) Animal
Care (AC) program. Among the findings, the report contends that
during inspections some inspectors "did not verify the number
of animals used in medical research or adequately review the facilities'
protocols and other records." In addition, the report contends
that "some institutional animal use and care committees (IACUCs)
are not effectively monitoring animal care activities or reviewing
protocols."
The IG made a number of recommendations to the Administrator of
APHIS. The IG recommends that the Department seek legislation to
increase fines up to $10,000 for research facilities. In addition,
it urges the AC to emphasize the need for more detailed reviews
of protocols, require research facilities to identify annually the
number of protocols in their annual reports, and require inspectors
to verify the number of animals used in research. The IG also recommends
that regulations require IACUCs to conduct more frequent reviews
of facilities identified as repeat violators and that IACUCs be
required to implement policies to fully train committee members
on protocol review, facility inspections, and the Animal Welfare
Act.
In responding to the report, APHIS says it will implement most
of the proposed changes.
Information:
Tony Mazzaschi, Interin Chief Scientific Officer, Senior Director
AAMC Scientific Affairs
tmazzaschi@aamc.org
(202) 828-0059
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