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Senate Appropriators Explore Supplemental Funding Request, Response to Ebola Outbreak

November 14, 2014—The Senate Appropriations Committee held a Nov. 12 hearing to discuss the government’s response to the Ebola outbreak and the administration’s supplemental funding request to address the epidemic domestically and internationally [see Washington Highlights, Nov. 7]. The AAMC submitted written testimony  for the record in advance of the hearing.

Secretary of Health and Human Services (HHS) Sylvia Burwell was among the witnesses testifying at the hearing and was accompanied by Centers for Disease Control and Prevention (CDC) Director Tom Frieden, M.D., and National Institute of Allergy and Infectious Diseases (NIAID) Director Anthony Fauci, M.D.

During her opening remarks, Senate Appropriations Chair Barbara Mikulski (D-Md.) said, “we must offer our full support to [state and local health departments] along with the disease detectives at the Centers for Disease Control and Prevention (CDC), the scientists developing vaccines and treatments at National Institutes of Health (NIH) and those at the Food and Drug Administration (FDA) who are working to ensure the safety and efficacy of any new vaccines or treatments.”

Senator Mikulski stressed that Ebola “meets the criteria for emergency spending,” because it is “sudden, unanticipated, unforeseen, urgent, and temporary,” and therefore separate from the fiscal year (FY) 2015 appropriations bills.

Senator Tom Harkin (D-Iowa), who will be ending his tenure as chair of the Labor-HHS Appropriations Subcommittee at the end of this year, emphasized the importance of continued and sustained investments in research and building public health infrastructure in the United States and abroad to detect and stop diseases before they become epidemics. He stated, “Yet… when new viruses are emerging and old viruses are becoming drug-resistant, we have reduced our investments in agencies like NIH and CDC, enacting short-sighted cuts that have left us less prepared.”

Sen. Mike Johanns (R-Neb.) expressed concern that the administration’s funding request did not include funds to reimburse institutions, such as Emory University in Georgia and the University of Nebraska Medical Center in his state, for treating Ebola patients and preparing health professionals. He called the lack of funding an “oversight” said it would be appropriate to provide funding because “treating an Ebola patient is a world different” than treating someone with the flu. In response, Secretary Burwell said institutions can negotiate with private insurers on compensation for these costs, but Senator Johanns pushed back saying insurers only cover “a minuscule amount” and not true costs.

Sen. Johanns also expressed his support for a regional model of care because not all hospitals may want or be able to accept and treat patients. “Treating an Ebola patient is very, very challenging, and there is risk involved if it's not done correctly,” he added.

The AAMC statement submitted for the record describes how medical schools and teaching hospitals are engaged in the Ebola response and expresses support “for a robust, sustained federal investment in preparing and equipping institutions to screen, refer, and care for Ebola patients in the United States.”

The statement further emphasizes that federal support should be sensitive to the unique operational challenges institutions may encounter, such as reimbursement from private and public payers for costly and lengthy hospitalizations, public relations challenges, the unique costs associated with employee training and infrastructure changes, and lost clinical revenues.

The statement also references a Nov. 5 letter to White House Ebola Response Coordinator Ron Klain where more than 120 medical schools and teaching hospitals from 35 states and the District of Columbia expressed their readiness to work with state and federal officials in preparing for and responding to possible Ebola cases [see Washington Highlights, Nov. 7].

During the hearing, appropriators also discussed Mr. Klain’s role, the safety of military personnel and healthcare professionals involved in the response, travel and visa bans, and quarantine protocols.


Tannaz Rasouli
Sr. Director, Public Policy & Strategic Outreach
Telephone: 202-828-0525

Alexandra Khalife
Legislative Analyst
Telephone: 202-828-0418


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