Full Bill: HR 3590 Patient Protection and Affordable Care Act

Senator Reid’s bill includes a public insurance option with a state opt-out, and creates state-based insurance exchanges to expand access to affordable insurance and create new non-profit co-ops. Initial procedural votes on the legislation could take place as early as this weekend. Analysis of the Senate health reform legislation will be available momentarily.

Given that the Senate companion bill to the House Student Aid and Fiscal Responsibility Act (SAFRA) has been linked to the passage of health care reform, student aid reform remains on hold. Leaders on the Hill have indicated that both chambers will likely be in session until the third full week of December.

Passage of health care reform may be linked to the student aid overhaul that was approved in the House over the summer. If Senate Democrats are unable to pull together the 60 votes necessary to pass health care reform, they may tie the legislation to the student aid bill in the form of a budget reconciliation package that would only require a simple majority to pass. As a result, the Senate companion to the House (H.R. 3221) student aid bill is currently awaiting further developments on the health care reform front. The University of Washington, and much of the higher education advocacy community, is using the extra time allotted for the student aid bill to seek some improvements in the legislation.

President Obama stated that the more than 12,000 grants awarded at NIH would “support cutting-edge medical research in every state across America.”  He added, “We know that this kind of investment will also lead to new jobs: tens of thousands of jobs conducting research, manufacturing and supplying medical equipment, and building and modernizing laboratories and research facilities.”

White House Press Release

The guidance crafted by the scientists and doctors at the CDC is designed to help colleges and universities start planning and acting now for the impact that seasonal and 2009 H1N1 influenza could have this fall and winter on their students and faculty members, as well as other university employees.  

Government officials are especially concerned about the impact of H1N1 on schools because the virus appears to disproportionately affect young people. The CDC’s Advisory Committee on Immunization Practices recently found that younger Americans, specifically those ages 6 months to 24 years, are one of the top priority groups when it comes to the new H1N1 vaccine.

HHS has created a special toolkit for administrators and students, as well some badges and widgets that can be used on social media sites such as Facebook and Twitter

The new guidance suggests that the most important actions institutions can take are: to encourage and facilitate good hand washing and covering coughs and sneezes; to encourage flu vaccination for recommended groups when vaccine becomes available; and to separate sick people from well people as soon as possible.

The Secretaries and the CDC stressed the need for different institutions to tailor the strategies to their own circumstances, based on their location, student population, resources, and information from local health officials about the severity and spread of flu in their area, and encouraged them to partner with local health officials and others in their community to plan for the upcoming flu season.

For the complete H1N1 guidance for higher education institutions and the special H1N1 Higher Education, please visit http://www.flu.gov/plan/school/higheredguidance.html.

The Toolkit is available at http://www.flu.gov/plan/school/higheredtoolkit.html.

The $200 million will be directed to the following program areas:

• $80.2 million for scholarships, loans, and loan repayment awards to students, health professionals, and faculty. Of those funds, $39 million will be targeted to nurses and nurse faculty, $40 million to disadvantaged students in a wide range of health professions, and $1.2 million to health professions faculty from disadvantaged backgrounds.
• $50 million in grants to health professions training programs. Funds will be used to purchase equipment needed to expand programs and improve the quality of training.
• $47.6 million to support primary care training programs. These funds will support the training of residents, medical students, physician assistants, dentists and individuals, many of whom will practice in underserved areas.
• $10.5 million to strengthen the public health workforce. Funds will support public health traineeships and increase the number of individuals trained through preventive medicine and dental public health residencies.
• $10.2 million to increase the diversity of the health professions workforce.
• And $1.5 million to support the efforts of state professional licensing boards in reducing barrier to telemedicine.

HRSA is using a competitive process to award all funds. Some awards will be made over the next several months.  In addition, funding opportunities for some programs will be announced over the next several months, giving applicants adequate time to prepare materials.  The remaining $300 million in ARRA workforce funds is being used to expand HRSA’s National Health Service Corps, which provides scholarships and loan repayment for primary care providers who serve in health professional shortage areas.  In addition, HRSA received $2 billion through ARRA to expand health care services to low-income and uninsured individuals through its health center program.

On the Medicare side, some providers would see their Medicare payouts cut directly (with Medicare Advantage seeing a $156 billion reduction).  And in other areas, Medicare would “bundle” payments for a number of related services, with the goal of providing better, less costly care for patients.  Currently, Medicare typically reimburses providers for every procedure or test they do.

 Prevention and wellness measures of the bill include:

• Expansion of Community Health Centers;
• Prohibition of cost-sharing for preventive services;
• Creation of community-based programs to deliver prevention and wellness services;
• A focus on community-based programs and new data collection efforts to better identify and address racial, ethnic, regional and other health disparities;
• Funding to strengthen state, local, tribal and territorial public health departments and programs.

The bill expands the health care workforce through:

• Increased funding for the National Health Service Corp;
• More training of primary care doctors and an expansion of the pipeline of individuals going into health professions, including primary care, nursing and public health;
• Greater support for workforce diversity;
• Expansion of scholarships and loans for individuals in needed professions and shortage areas;
• Encouragement of training of primary care physicians by taking steps to increase physician training outside the hospital, where most primary care is delivered, and redistributes unfilled graduate medical education residency slots for purposes of training more primary care physicians. The proposal also improves accountability for graduate medical education funding to ensure that physicians are trained with the skills needed to practice health care in the 21st century.

Read more about the proposal.

If confirmed, Collins will head a $31 billion agency with roughly 18,000 employees. NIH is on course to receive a modest increase (1.4%) in funding in FY10, over FY09, because of significant funding ($10.4 billion) provided in the Recovery Act. NIH continues to serve as the University of Washington’s largest source of federal grant funding.

White House Press Release

SUMMARY: The National Institutes of Health (NIH) is hereby publishing final “National Institutes of Health Guidelines for Human Stem Cell Research” (Guidelines).

On March 9, 2009, President Barack H. Obama issued Executive Order 13505: Removing Barriers to Responsible Scientific Research Involving Human Stem Cells. The Executive Order states that the Secretary of Health and Human Services, through the Director of NIH, may support and conduct responsible, scientifically worthy human stem cell research, including human embryonic stem cell (hESC) research, to the extent permitted by law.

These Guidelines implement Executive Order 13505, as it pertains to extramural NIH-funded stem cell research, establish policy and procedures under which the NIH will fund such research, and helps ensure that NIH-funded research in this area is ethically responsible, scientifically worthy, and conducted in accordance with applicable law. Internal NIH policies and procedures, consistent with Executive Order 13505 and these Guidelines, will govern the conduct of intramural NIH stem cell research.

EFFECTIVE DATE: These Guidelines are effective on July 7, 2009.

SUMMARY OF PUBLIC COMMENTS ON DRAFT GUIDELINES: On April 23, 2009 the NIH published draft Guidelines for research involving hESCs in the Federal Register for public comment, 74 Fed. Reg. 18578 (April 23, 2009). The comment period ended on May 26, 2009.

The NIH received approximately 49,000 comments from patient advocacy groups, scientists and scientific societies, academic institutions, medical organizations, religious organizations, and private citizens. The NIH also received comments from members of Congress. This Notice presents the final Guidelines together with the NIH response to public comments that addressed provisions of the Guidelines.

Full NIH Guidelines on Embryonic Stem Cell Research