Washington Highlights: February
2 , 2007
ContentsPrior Issues  |
House Approves
Year-Long CR, NIH Gets $620 Million IncreaseThe House of Representatives
Jan. 31 approved a $463.5 billion full-year FY 2007 continuing resolution (CR)
by a vote of 286-140. The CR (H.J.Res.
20) provides a $2.3 billion increase for programs under the Labor-HHS-Education
Appropriations Subcommittee, including an increase of $619.5 million (2.2 percent)
above the FY 2006 funding level for the National Institutes of Health (NIH). A
summary released
by House Appropriations Chair David Obey (D-Wis.) states the increase will support
an additional 500 research project grants and 1,500 first time investigators.
The CR includes a new $91 million fund within the Office of the Director (OD)
of NIH to support new investigators. The CR implements several changes that
were mandated in the NIH Reform Act of 2006, which the President signed Jan. 15
(PL 109-687). The CR appropriates $483 million to the OD for the Common Fund.
In prior years, NIH institutes and centers (ICs) contributed a uniform percentage
of their appropriations to the Fund. The CR eliminates that transfer, which in
FY 2006 was about 0.9 percent of the individual IC budgets. The Common
Fund includes $40 million for a new "Junior" Pioneer awards program,
which will fund high-risk research with potentially high-impact returns. The remaining
$443 million in the Common Fund is a $113 million increase over the FY 2006 level. Most
ICs appear to be level-funded with the FY 2006 base. However, since they no longer
have to contribute to the Common Fund, they effectively will receive an increase
of about 0.9 percent over FY 2006. The resolution also includes $69 million,
an increase of $58 million, for the National Children's Study. The Administration's
FY 2007 budget had proposed eliminating the study because of its long-term cost.
When combined with the previously enacted FY 2007 defense and homeland
security appropriations, the CR remains within the overall $873 billion spending
cap, established by the Republican-led 109th Congress. As promised by Chairman
Obey and Senate Appropriations Chair Robert Byrd (D-W.Va.), the final CR does
not include earmarks for members of Congress. In a Statement
of Administration Policy (SAP) issued Jan. 30, the White House praised the
CR for holding to the original FY 2007 spending ceiling without further reductions
in defense spending and for the commitment to eliminate earmarks. However, the
Administration expressed disappointment "with the structure of H.J.Res. 20
and the process used to create it." The White House noted the CR "uses
a formulaic approach for much of the FY 2007 funding and fails to take into account
funding for new priorities and opportunities for savings. As a result, certain
high priority areas are not adequately addressed, and the Committee has missed
the opportunity to achieve significant savings for the taxpayer…." The
President is expected to sign the CR once it clears the Senate. The Senate
may begin consideration of the CR the week of Feb. 5. However, since the President's
FY 2008 budget comes out Feb. 5, the CR may slip to the week of Feb. 12. Since
amendments can be offered on the Senate floor, Senate action is expected to take
several days. The current CR (PL
109-383) expires Feb. 15. Information:
Dave Moore, Senior Director
AAMC Government Relations
dbmoore@aamc.org
(202) 828-0525 CR
Increases FY 2007 Health, Research FundingThe year-long FY 2007 continuing
resolution (H.J.
Res 20) passed by the House Jan. 31 includes increases over FY 2006 funding
levels for a number of discretionary programs of interest to medical schools and
teaching hospitals. The resolution provides $184.7 million for the Title
VII health professions programs, a $39.5 million (27 percent) increase above the
FY 2006 level of $145.2 million. The programs were funded at $300 million in FY
2005. The CR does not include the FY 2005 and 2006 rescissions from the Title
VII student loan programs. Title VII programs receiving increases in the
CR include the geriatrics training programs, which were eliminated in FY 2006,
and the primary care medicine and dentistry training programs. The resolution
restores the geriatrics programs to their FY 2005 level with $31.5 million for
FY 2007. The primary care medicine and dentistry training programs received $48.8
million for FY 2007, an $8 million (19.6 percent) increase above FY 2006. These
programs received $88.8 million in FY 2005. The resolution specifies that no less
than $24.6 million of the primary care and dentistry funding be for the family
medicine programs, while $5 million is designated for pediatric dentistry and
another $5 million for general dentistry. Additionally, the resolution provides
$1.2 billion for Ryan White CARE grants, an increase of $75.8 million (6.7 percent).
According to a summary provided by the staff of Senate Appropriations Committee
Chair Tom Harkin (D-Iowa), the increase will assist "states who are disadvantaged
by the new formula in the reauthorized program." The resolution also
provides $160 million for the Public Health and Social Services Emergency Fund,
of which $100 million is designated for CDC activities relating to pandemic flu
and other emerging infectious diseases. Research agencies listed under the
President's American Competitiveness Initiative for basic scientific research
also received a boost over FY 2006 levels. The resolution provides $4.7 billion
for research and related Activities at the National Science Foundation, an increase
of $335 million (7.7 percent), and the Department of Energy's Office of Science
receives $3.8 billion, an increase of $200 million (5.6 percent). A Statement
of Administration Policy issued Jan. 30 by the White House points out that H.J.
Res 20 provides only half the requested increase for research and "strongly
urges" Congress to provide the full increase requested in the President's
budget. The CR includes $32.1 billion for VA Medical Care, a $3.4 billion
(12 percent) increase over FY 2006. VA Research is funded at the FY 2006 level
of $412 million, but a 15 million "set-aside" for Gulf War Veterans
Illness research under the VA Medical and Prosthetic Research program is eliminated.
Information:
Matthew Shick, Senior Legislative Analyst
AAMC Government Relations
mshick@aamc.org
(202) 862-6116 Erica Froyd, Director, Public Health and Research Legislative Affairs
AAMC Government Relations
efroyd@aamc.org
(202) 828-0525
Tannaz Rasouli, Senior Legislative Analyst
AAMC Government Relations
trasouli@aamc.org
(202) 828-0525
AAMC Commends Legislation to Support State Health Coverage
InitiativesThe AAMC Jan. 23 sent a letter
of support for the bipartisan, bicameral "Health Partnership Act" (S.
325/H.R.
506), which would establish a new grant funding mechanism for state, local,
and Indian health coverage initiatives. Introduced by Sens. Jeff Bingaman (D-N.M.)
and George Voinovich (R-Ohio), as well as Reps. Tammy Baldwin (D-Wis.), Tom Price
(R-Ga.), and John Tierney (D-Mass.), the legislation is intended to promote the
development of innovate coverage strategies. It also establishes a "State
Health Innovation Commission" to identify which strategies could be implemented
nationally. In the letter, AAMC President Darrell Kirch, M.D., commends
the legislation for "providing a unique opportunity to develop and evaluate
state initiatives to cover the uninsured." He also applauds the bills for
providing policy makers with "valuable information and insight as they work
toward healthcare reform at the Federal level." Information:
Christiane Mitchell, Senior Legislative Analyst
AAMC Government Relations
cmitchell@aamc.org
(202) 828-0526
House
Letter Urges Congressional Action to Stop Medicaid Proposed Rule Reps.
Anna Eshoo (D-Calif.) and Peter King (R-N.Y.) are circulating a Medicaid sign-on
letter to the Chairmen and Ranking
Members of the House Committee on Ways and Means and the House Committee on Energy
and Commerce. The bipartisan letter urges Congressional action to stop implementation
of a Jan. 18 proposed rule that would cut an estimated $3.87 billion in Medicaid
funds. The proposed rule would have an impact on providers by limiting Medicaid
payments to public providers, narrowing the definition of "public providers,"
restricting sources that may be used to fund the non-federal Medicaid share, and
requiring providers to retain the full amount of their Medicaid payments. Without
congressional action, the rule will become effective Sept. 1, 2007. Warning
that the proposed rule would "likely increase the number of uninsured Americans"
and "tie the hands of individuals and organizations that serve them,"
the letter calls for a "legislative proposal that will prevent the Centers
for Medicare and Medicaid Services from moving forward with...this dangerous and
unfair rule." Information:
Christiane Mitchell, Senior Legislative Analyst
AAMC Government Relations
cmitchell@aamc.org
(202) 828-0526
Senate
Panel Approves Genetic Nondiscrimination BillThe Senate Health, Education,
Labor and Pensions (HELP) Committee Jan. 31 approved the Genetics Information
Nondiscrimination Act (S. 358), by a vote of 19-2, clearing the bill for expected
passage by the full Senate. Similar bills have passed the Senate in 2003 and 2005.
The legislation forbids health insurers and employers from requiring individuals
to submit to genetic testing, or from using genetic information to make insurance
or employment decisions. AAMC President Darrel G. Kirch, M.D., Jan. 23 sent letters
of support to the bill's sponsor Sen. Olympia Snowe (R-Maine), and Senate HELP
Committee Chair Edward Kennedy (D-Mass.) and Ranking Member Mike Enzi (R-Wyo.). The
House Education and Labor Subcommittee on Health, Employment, Labor and Pensions
Jan. 30 held a hearing on the House bill (H.R.
493) [see Washington Highlights,
Jan. 19]. The bill's sponsors, Reps. Louise Slaughter (R-N.Y.) and Judy Biggert
(R-Ill.), testified on the importance of protecting genetic information to ensure
individuals will not be dissuaded from taking genetic tests. While the bill previously
has stalled in the House due to the business community's concern for increased
lawsuits, it is expected to pass the Democratic-controlled House this year. The
President has stated his support for the bill. Information:
Erica Froyd, Director, Public Health and Research Legislative Affairs
AAMC Government Relations
efroyd@aamc.org
(202) 828-0525
Administration Sets New Procedures for Guidance
DocumentsThe Administration has issued new guidelines
for federal agencies that produce "significant guidance documents."
The new rules, issued by an executive
order and by the Office of Management and Budget (OMB), require that guidance
documents produced by government agencies be reviewed first by the OMB to ensure
that the documents are consistent with applicable law, the President's priorities,
and other principles set forth by the Administration. The new guidelines also
will require that all significant guidance documents be subject to public notice
and comment; however, government agencies will not be required to respond formally
to these comments, as is the case when regulations are proposed. These changes
will be effective 180 days after publication in the Federal Register. Many
Federal agencies have used guidance documents to provide information requested
by the regulated community more quickly than could be done through a formal rulemaking.
The new requirements are likely to slow their issuance. The AAMC submitted a comment
letter in January 2006 recommending that senior agency officials, not OMB, be
responsible for approving significant guidance documents and for establishing
approval procedures [see Washington
Highlights, Jan. 20, 2006].
According to the letter, "these officials are accountable for the responsiveness
of the agency and best understand the role of guidance in the context of the policies
and mission of these agencies." Information:
Ivy Baer, Director & Regulatory Counsel
AAMC Health Care Affairs
ibaer@aamc.orc
(202) 828-0490
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