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Washington Highlights: June 8, 2007

House Appropriations Panel Approves Subcommittee Allocations

The House Appropriations Committee June 5 gave formal approval to its subcommittee allocations for FY 2008. The so-called 302(b) allocations set spending limits for each of the 12 appropriations subcommittees. Overall, the Appropriations Committee divided $953 billion among the 12 subcommittees, an increase of $80.3 billion (9.2 percent) over the current year's funding level and $20.2 billion more than the Administration's FY 2008 budget.

The Labor-HHS-Education Subcommittee received an allocation of $151.1 billion, an increase of $6.6 billion (4.6 percent) over the current year's funding level and $10.2 billion more than the President's request. The Military Construction-Veterans Committee received $64.7 billion, an increase of $15 billion (30 percent) over the current year's funding level and $4 billion more than requested by the President.

The Senate Appropriations Committee is expected to release its subcommittee allocations later this month.

Information:
Dave Moore, Senior Director
AAMC Government Relations
dbmoore@aamc.org
(202) 828-0525

House Subcommittee Approves FY 2008 HHS Spending Bill

The House Labor-HHS-Education Appropriations Subcommittee June 7 approved its FY 2008 spending bill. The subcommittee was working with an allocation of $151.1 billion, an increase of $6.6 billion (4.6 percent) over the current year's funding level (see related story). Overall, the subcommittee's bill provides $46.5 billion for Public Health Service programs, an increase of $1.98 billion (4.4 percent) over the current year's funding level.

For the National Institutes of Health, the bill provides $29.650 billion, an increase of $750 million (2.6 percent) above the current year's funding level and $1.029 billion (3.6 percent) above the President's request. However, the bill also increases the amount of the transfer from NIH to the Global HIV/AIDS fund from the $99 million in FY 2007 to $300 million in FY 2008, which means the net increase in the NIH budget is $549 million (1.9 percent) over FY 2007.

The NIH total includes $495 million for the common fund, appropriated directly through the Office of the Director. This is an increase of $12 million (2.5 percent), and the common fund remains at 1.67 percent of the total NIH appropriation.

The bill provides $228.3 million for Title VII health professions programs, a $43.6 million (23.6 percent) increase over FY 2007. The Title VII Centers of Excellence and Health Careers Opportunity Programs each receive $28.4 million, for a $16.6 million (139 percent) increase and $24.5 million (618 percent) increase, respectively. The primary care medicine and dentistry programs are level funded at $48.9 million, while the Area Health Education Centers receive a $2.5 million (8.9 percent) increase over the current funding level.

The bill also includes $165.7 million for Title VIII nursing programs, for a $15.9 million (10.7 percent) increase. Within Title VIII, the nurse loan repayment and scholarship program is increased by $12.9 million (41.7 percent), while the nurse faculty loan program receives a $3 million (62.9 percent) increase.

The subcommittee did not include a $100 million rescission from the Title VII and VIII student loans programs proposed by the President for FY 2008. The President's budget request would recall the "Federal portion of the liquid assets" from the Health Professions Student Loan, Loans for Disadvantaged Students, the Primary Care Loan, and the Nursing Student Loan. Congress did not include the President's proposed rescission in the FY 2007 joint funding resolution.

The bill provides $131.5 million for the National Health Service Corps (NHSC), a $5.8 million (4.6 percent) increase over FY 2007 and $14.8 million (12.8 percent) above the President's request. The subcommittee bill funds the NHSC Field appropriation at $40 million, the same as in FY 2007. The NHSC Recruitment appropriation, which provides for Scholarship and Loan Repayment awards, is increased to $91 million, a $6 million (6.6 percent) increase over the FY 2007 level.

The bill includes $307 million for Children's Hospitals Graduate Medical Education, an increase of $10 million (3.3 percent) over the current year's level.

The bill provides $329.6 million for the Agency for Healthcare Research and Quality (AHRQ), which is a $10.6 million (3.3 percent) increase above FY 2007. $30 million is allocated for clinical effectiveness research, a $15 million increase above last year, while patient safety research is cut by $5 million to $79 million for FY 2008. All of the AHRQ funding is a direct appropriation, rather than transfers from other agencies, which is how the agency was funded in FY 2007 and in the President's proposed FY 2008 budget.

The Ryan White AIDS programs receive $2.212 billion for a $99.2 million (4.7 percent) increase over last year. Within this, the AIDS Drug Assistance Program (ADAP) receives $830.6 million, a $41 million (5.2 percent) increase.

For the Centers of Disease Control and Prevention (CDC), the bill provides a program level of $6.449 billion, an increase of $183 million (2.9 percent) over FY 2007.

The bill includes $1.7 billion within the Public Health and Social Service Emergency Fund for biodefense and other activities, including $948.1 million for pandemic flu preparedness. Within the CDC budget, the bill provides $1.6 billion for terrorism preparedness and response, which is a $48 million (3.1 percent) increase above last year.

The subcommittee bill includes $107 million for the National Institute on Disability and Rehabilitation Research within the Department of Education, equal to the President's request and the FY 2007 level.

The full House Appropriations Committee is tentatively scheduled to consider the bill June 14, with House floor action the following week.

Information:
Dave Moore, Senior Director
AAMC Government Relations
dbmoore@aamc.org
(202) 828-0525

Erica Froyd, Director, Public Health and Research Legislative Affairs
AAMC Government Relations
efroyd@aamc.org
(202) 828-0525

Matthew Shick, Senior Legislative Analyst
AAMC Government Relations
mshick@aamc.org
(202) 862-6116

Tannaz Rasouli, Senior Legislative Analyst
AAMC Government Relations
trasouli@aamc.org
(202) 828-0525

House Panel Approves VA Appropriations

The House Appropriations Committee June 6 approved (56-0) the FY 2008 spending bill for Military Construction and Veterans Affairs (VA). The bill provides $36.6 billion for VA medical care, a $4.5 billion (14 percent) increase over the FY 2007 joint funding resolution and $2.4 billion (7.1 percent) above the President's budget. For the first time, the total budget for VA health care budget exceeds (by $294 million) the recommendation in the Independent Budget proposal by veterans service organization and endorsed by the Friends of VA Medical Care and Health Research (FOVA).

The bill provides $480 million for the VA Medical and Prosthetic Research program, a $66.3 million (16 percent) increase over the FY 2007 includes joint funding resolution and a $69 million (16.8 percent) above the President's budget. The FY 2007 Emergency Supplemental (P.L. 110-28) includes an additional $32.5 million for VA research [see Washington Highlights, May 25] bringing the FY 2007 total to $446.2 million. The AAMC, as an executive member of the FOVA coalition, recommends $480 million for VA research.

VA Appropriations Subcommittee Chair Chet Edwards (D-Texas) has indicated the bill will be on the House floor as early as June 13. The Senate Military Construction and Veterans Affairs (VA) Appropriations Subcommittee is scheduled to consider its version July 12.

At $64.7 billion, the total bill provides $4 billion more than the President's budget. The White House has threatened to veto any spending bills exceeding the President's requests.

Information:
Matthew Shick, Senior Legislative Analyst
AAMC Government Relations
mshick@aamc.org
(202) 862-6116

AAMC Comments on FDA's Draft Guidance for Adverse Event Reporting

The AAMC June 6 sent a comment letter to the Food and Drug Administration (FDA) in support of their draft guidance for Clinical Investigators, Sponsors, and Investigational Review Boards on Adverse Event Reporting - Improving Human Subject Protection. The draft guidance is consistent with the recommendations of the AAMC and other organizations provided at an FDA hearing in March 2005.

The draft guidance addresses the inundation of Institutional Review Boards (IRBs) with large volumes of individual adverse event reports that -- due to lack of context, detail, and analysis of clinical significance -- hamper the ability of IRBs to protect the rights and welfare of human subjects. The FDA recognizes that the IRB sponsor has the expertise, breadth of data, and responsibility for analyzing adverse events and determining if an unanticipated problem exists. Additionally, the FDA provides specific guidelines on what constitutes a reportable unanticipated problem.

The AAMC comment letter also includes a number of suggestions to further improve the draft guidance.

Information:
Howard Dickler, Director
AAMC Biomedical Health Sciences Research
hdickler@aamc.org
(202) 828-0567

House Clears Stem Cell Research Bill

The House June 7 passed (247-176) the "Stem Cell Research Enhancement Act of 2007" (S.5) clearing the measure for the President. The bill would allow federal funding for research on new human embryonic stem cell lines, overturning President Bush's 2001 ban [see Washington Highlights, April 13]. President Bush plans to veto the measure when he returns from travel June 11. The House is unlikely to garner the two-thirds majority necessary to override the President's veto.

At June 7 event in the U.S. Capitol, Coalition for the Advancement of Medical Research (CAMR) President Sean Tipton joined patients and their families as well as scientists and others in the medical community to thank the House and Senate for their strong bipartisan support and passage of S. 5. The AAMC is a member of the CAMR Executive Board.

Information:
Tony Mazzaschi, Senior Director
AAMC Scientific Affairs
tmazzaschi@aamc.org
(202) 828-0059

Matthew Shick, Senior Legislative Analyst
AAMC Government Relations
mshick@aamc.org
(202) 862-6116

Members of Congress Oppose Hospital Cuts Proposed in Medicare IPPS Rule

A total of 63 Senators signed onto a letter dated June 5 to CMS Acting Administrator Leslie Norwalk expressing opposition to a portion of CMS' FY 2008 Medicare Inpatient Prospective Payment System (IPPS) proposed rule that cuts $25 billion in hospital inpatient operating and capital payments. The letter was spearheaded by Senators Ken Salazar (D-Colo.) and Pat Roberts (R-Kansas).

The Senate letter states the proposed cuts would "jeopardize beneficiary access to critical hospital services" and "stifle hospital investment in technology that will increase patient quality and reduce health care costs."

In the FY 2008 IPPS proposed rule, CMS includes a 2.4 percent cut to operating and capital payments in FYs 2008 and 2009. The cut is intended to eliminate the effect of coding or classification changes CMS claims would not reflect real changes in case-mix. The agency also would freeze capital payments for all urban hospitals (a 0.8 percent cut) and eliminate the capital payment add-on for large urban hospitals (an additional 3 percent cut). The AAMC will submit a comment letter. Comments are due June 12.

Information:
AAMC Government Relations