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Office of External Affairs: Federal Relations

Health/Medical

Posted by Jonathan Nurse on November 19, 2009 at 11:03 am 

Last night, Senate Majority Leader Harry Reid (D-NV) released the long awaited health insurance reform package that merges bills advanced by the Senate Health, Education, Labor and Pensions (HELP) Committee and the Senate Finance Committee. The Congressional Budget Office estimates that the legislation, the Patient Protection and Affordable Care Act (H.R. 3590), would cost roughly $848 billion over 10 years and to extend coverage to 31 million people by 2019. However, it would leave 24 million without coverage.

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.

Posted by Jonathan Nurse
November 19, 2009 at 11:03 am
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Posted by Christy Gullion on October 26, 2009 at 6:27 am 

The House and Senate continue to negotiate a health care reform bill, which has left some open time for both chambers to consider FY10 appropriations bills.  The first order of business this week will be to extend the current continuing resolution (CR) for most federal agencies since the current CR expires on Saturday, October 31st.

FY10 Appropriations

Last week congressional leaders discussed including the extension into the conference report on the Interior-Environment appropriations bill, similar to how the original one-month CR was added in conference to Legislative Branch spending bill.  They decided against this path forward likely because the Interior bill may face controversy over unrelated provisions.  The CR extension is expected to go to December 15th, a little more than a week before Christmas.  To date, Congress has completed action on just four of the 12 spending bills for the fiscal year that began on October 1 (Agriculture, Energy & Water, Homeland Security, and Legislative Branch).  The UW has secured two earmarks in the Energy & Water bill.  The first is a $1 million mark for biofuels work and the second is $880,000 for accelerating research on tidal energy production.

The Interior-Environment appropriation bill is scheduled for House action this week if an agreement can be reached on one controversial provision related to EPA regulation of vessel emissions on the Great Lakes.  The UW College of the Environment stands to gain a $4 million earmark in that bill to conduct, compile, and disseminate research on how best to restore and protect the Puget Sound.

The House is also scheduled to consider a bill that would reauthorize Small Business Administration (SBA) programs that provide entrepreneurs with access to capital.  The legislation is a combination of eight bills that would extend some stimulus programs that allowed the SBA to increase loans, provide more capital to low-income areas and renewable-energy industries, and make loan guarantees to small health care firms purchasing health information technology.

The Senate may try to take up the Commerce-Justice-Science bill after pulling it from floor consideration last October 13th after Democrats failed to come up with enough votes to limit debate and amendments to the bill.  One amendment that is holding up progress would require the 2010 Census to include questions about citizenship and immigration status, which is opposed by the Obama Administration.

Meanwhile, the Senate will focus on the economy this week and try to finish a bill that would extend unemployment benefits.  The measure would provide an additional 14 weeks of benefits to unemployed individuals nationwide and would give six more weeks on top of that to states with a three-month average unemployment rate of at least 8.5 percent.  The Senate may also take up its FY10 Military Construction-VA appropriations bill.

Because the appropriations process has been slow this fall, mostly due to the health reform debate, Congress is now thinking that a year-end omnibus bill may be necessary to complete the remaining FY 10 appropriations bills.  Additionally, the remaining appropriations measures may be used to enact further legislation to help the unemployed and boost job creation.

Health Reform

Debate on health care reform is not expected to begin until next week at the earliest, as Democratic leaders in both chambers are still trying to finalize the legislation they intend to bring to the floor. The House hopes to release their renegotiated health reform measure this week so that they can vote on the package by November 6th.  It is possible, that the House will work through that weekend and into Monday and Tuesday before taking a small break for Veterans Day. 

Unveiling the bill would answer questions about the shape of the public option and clear the way for final decisions on how to raise revenue to pay for it.  While House liberals are looking for a public plan based on Medicare rates, House Leaders are leaving room for moderates’ preferred version after Senate Democrats indicated they were likely to include a public option in their overhaul.  Leaders still have a few thorny issues to resolve before they introduce a bill, such as questions about abortion services, insurance for immigrants, cost of medical devices, and hospital payments.

Meanwhile, the Senate continues to work on merging the two reform bills from the Senate Finance and HELP committees, and appears to be moving toward a stronger public option than currently included in the Senate Finance Committee bill.  Senate Democratic leaders have other issues to resolve, including whether the final bill would include an employer mandate; a long-term insurance program for those who become disabled; financing to make up for revenue lost by increasing the value of plans considered high cost that would be taxed under the bill; and how to make premiums more affordable since individual coverage will be required by law.

Energy and the Environment

The Senate Environment & Public Works Committee will hold three days of hearings this week on a revised draft of climate change legislation the panel is looking to mark up soon.  On Tuesday, the committee will hear from five administration officials – Energy Secretary Chu, Interior Secretary Salazar, Transportation Secretary LaHood, EPA Administrator Jackson, and Federal Energy Regulatory Commission (FERC) Chairman Wellinghoff.

Last week, the House passed legislation that would lead to the creation of a federal research strategy for solar energy.  The bill (HR 3585) directs the Energy Department to establish a Solar Technology Roadmap Committee, which would develop a comprehensive federal solar research plan.  Bill supporters noted rapid growth in solar manufacturing by European nations and China in recent years.  The bill would authorize $350 million for the Energy Department in fiscal 2011, rising to $550 million in fiscal 2015, for a total of $2.25 billion over the five-year period.  Some members expressed concerns about the high cost of the bill even while supporting the underlying goals.   

The roadmap committee created by the bill would include at least 11 members appointed by the Energy secretary within four months of the bill’s enactment.  At least one-third of the members — but not more than half — would be required to come from the solar industry.  The bill also would require the appointment of a chairman from outside the federal government.  Within 18 months of enactment, the committee would be required to chart a course for research, development, and demonstration activities between the federal government and the private sector.  The Energy secretary would be directed to award merit-based grants for projects, with an emphasis on solar manufacturing research performed by industry-led consortia.

FY11 Appropriations

Today is the deadline for submitting proposals for the FY11 federal agenda.  Proposals will be reviewed and evaluated over the next several weeks.  In January 2010, the Office of Federal Relations will share the results of that work when we present our FY11 Federal Agenda.  If you have any questions about this process, please contact me or Jonathan Nurse.

Posted by Jonathan Nurse on October 14, 2009 at 10:45 am 

Yesterday, 10/13/09, the Senate Finance Committee approved a health reform package on a largely party-line vote of 14-9, with only Senator Olympia Snowe (R-ME) crossing the partisan divide. The vote in Senate Finance was the last of the five House/Senate committee (3 House committees, 2 Senate Committees) votes before consideration by the chambers.  Leadership and select members of the committees of jurisdiction will need to work together to merge bills that have been produced. In the Senate, the reform package will need to clear 60 votes to avoid a filibuster, while in the House only a simple majority is needed. At present, a public insurance option appears to be the major point of contention between the more conservative version of reform produced by the Senate Fiance Committee  and legislation advanced by the Senate HELP Committee and the House. After bills pass the Senate and House, differences will again need to be worked out between the chambers so that a single bill can be sent to the President.

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.

Posted by Christy Gullion on September 28, 2009 at 6:12 am 

The congressional agenda this week will sound familiar to those who have been following the action:  Both chambers will focus on appropriations measures as the fiscal year winds down on September 30th, and Senate and House committees will continue to resolve differences on health care reform proposals.

Appropriations

Congress has until Wednesday night to pass a continuing resolution (CR) to keep the government running when FY10 starts on Thursday. The CR being discussed in the Senate would give lawmakers in that chamber 30 days to finish work on the FY10 spending bills.  But the healthcare measure is also expected to come to the floor within a few weeks so many believe an additional extension will likely be needed.

The CR is needed to give lawmakers additional time after the end of the fiscal year Wednesday to complete the 12 annual appropriations bills.  The House has finished work on all 12, while the Senate has completed only five.  It is close to wrapping up work on the FY10 Interior-Environment Appropriations bill.  Under the CR, most government programs will be funded at FY09 levels, with a few exceptions such as veterans’ health care and the Census Bureau.

Meanwhile, the House will take up conference reports on a handful of spending bills this week if House and Senate differences over earmarks can be resolved. The controversy rests with earmarks designated for private, for-profit entities.  In response to complaints that earmarks are a source of corruption, House appropriators added provisions to their appropriations bills requiring that earmarks to for-profit entities undergo a competitive bidding process.   The Senate, however, did not agree with this move.  Late last week, House and Senate leaders reached an agreement:  House earmarks designated for private, for-profit entities will be competitively bid, Senate earmarks will not, and those earmarks that are listed in both bills will not be competitively bid this year but will in future years.  One thing is certain, the earmark process will continue to morph as congress injects more and more transparency into the process.

Overall, Democrats plan to spend $75 billion, or 7 percent, more in fiscal 2010 than they did in fiscal 2009 on the 12 annual spending bills, not including emergency spending.

The Office of Federal Relations continues to monitor the earmarks that we have secured in the House bills.  The next hurdle is to protect those earmarks as they move through the conference negotiations. 

Health Reform

The health care debate will continue to take center stage in both chambers as lawmakers continue to look for a path forward.  Senate leaders continue to say that a health bill could be on the floor by the end of the week.  While that timetable appears unlikely, it is clear Democrats want to move the bill as soon as possible, with one of the unknowns being how long it will take congressional budget office to score a bill once versions crafted by the two committees – Finance and Health, Education, Labor and Pensions (HELP) – are merged.

The House continues to push toward having a single bill crafted from the work of three committees, which they hope to have finalized by the end of the week and ready for floor action the following week. 

The Office of Federal Relations is working closely with the health sciences schools (medicine, dentistry, nursing, public health, etc.) to protect graduate medical education funding and ensure that programs and grants being proposed through health reform have a positive impact on those entering the health professions.

As always, please let us know if you have questions or would like to discuss how to engage the congressional delegation with your issues and concerns.

Best,

Christy Gullion, Director

Posted by Christy Gullion
September 28, 2009 at 6:12 am
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Posted by Christy Gullion on September 14, 2009 at 6:11 am 

This week, lawmakers will attempt to clear the decks of routine legislative business on the floors of each chamber so that they can continue to give their full attention to how to move major aspects of Democrats’ signature priorities: healthcare reform and climate change legislation.

The House will take up a bill to overhaul the federal student loan system, which has become a top priority for President Obama.  The bill would eliminate the Federal Family Education Loan Program and replace it with the Direct Lending Program administered by the US Department of Education.  It is estimated that this bill could save up to $87 billion, with some of those savings being used to increase Pell Grants and reduce the federal deficit. 

The House will also consider legislation that will provide for an Energy Department program for the research, development, demonstration and commercial application of vehicle technologies.

The Senate plans to finish work on the FY10 Transportation-HUD spending bill early this week, with the first votes on amendments to that measure tonight and stretching into Tuesday.  It is clear that they won’t meet the September 30th deadline so a short-term continuing resolution is all but assured.

The Senate Finance Committee is expected to release its long-awaited health care overhaul legislation in advance of a markup. The committee needs to make final decisions on prohibiting federal funds for abortions, changes to the medical malpractice system, and expanding Medicaid.  Democratic leaders have a Tuesday deadline to come up with a bipartisan proposal before Democrats decide to go it alone on a measure, an option that could involve budget reconciliation procedures.

Budget reconciliation is a senate procedure that would allow the majority party to limit debate and approve a measure with only 51 votes as opposed to the usual 60.  Reconciliation, enacted in 1974 to reduce the budget deficit through better legislative discipline, is designed to align, or reconcile, existing spending laws with the annual budget resolution adopted by the House and Senate.  Unlike most other measures, reconciliation bills are immune to a filibuster (which requires 60 votes to overcome). In years past, both parties have used the procedure to advance policy changes that have had little or nothing to do with deficit reduction.

The use of reconciliation does come with some risks to the majority party.  The rule allows any senator to raise a point of order to strike out parts of a reconciliation measure that are found not to be budget issues.  To a large degree, it is the Senate parliamentarian — an appointee of the majority leader — who makes the call on what does and does not qualify for a spot in a reconciliation bill.  In the case of health reform, the Senate Democrats run the risk of having some portions of their health bill removed from consideration.

It will also be a busy work for the Office of Federal Relations.  Several members of the UW community are in DC this week for a variety of national meetings.  President Emmert will attend the Coalition of Universities for Global Health and participate in a panel discussion with his colleagues from other universities.  He will also visit with agency officials and Members of Congress.  Other faculty members will also be on the Hill this week advocating for global health initiatives and geological/seismic policy priorities.  We are also looking forward to seeing other members of the UW community in DC in the next few weeks.

Christy Gullion, Director

Posted by Christy Gullion
September 14, 2009 at 6:11 am
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Posted by Christy Gullion on September 7, 2009 at 2:48 pm 

Congress returns to work this week after a fractious August recess during which lawmakers were confronted about the public health insurance option and other contentious elements in Democratic health reform bills.  Policy experts already are identifying less controversial proposals that could attract support from moderate Democrats and even some Republicans.

Lawmakers hope to come up with a compromise on health reform by the middle of October.  If no compromise is found, it’s likely they will try to enact a series of smaller health measures. 

President Obama will address a joint session of Congress on Wednesday to discuss health care overhaul legislation. Health care negotiations in both chambers are expected to dominate legislative business for much of the fall. 

Meanwhile, it seems all but certain that Congress will not be able to complete all twelve FY10 appropriations bills before the next fiscal year begins Oct. 1st.  Lawmakers will likely has to pass a continuing resolution (CR) later this month to fund federal agencies when FY10 begins. 

House and Senate leaders still hope to avoid an omnibus package.  Completing all of the bills individually will depend largely on how quickly the Senate acts on its eight remaining measures. 

The House has passed all twelve of their FY10 bills, but none of the measures has gone to conference or been enacted into law.  Four bills that both chambers have approved – Agriculture, Energy-Water, Homeland Security, and Legislative Branch – will likely be sent to the President for signature before October 1st

The Senate is expected to take up three of their FY10 spending bills this week, including Transportation-HUD, Interior-Environment, and Commerce-Justice-Science. The Defense spending bill will follow late this week or next, after subcommittee markup on Wednesday. 

Even with the busy legislative schedule this fall, we are looking forward to seeing several members of the UW community in DC and on Capitol Hill.  If you are planning on being in DC this fall, please get in touch with our office so that we can coordinate all the visits – and to ensure that you are getting appointments with the folks you need to see.  As always, we are here to help you advocate for your projects and programs! 

Christy Gullion, Director

Posted by Christy Gullion
September 7, 2009 at 2:48 pm
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Posted by Christy Gullion on August 21, 2009 at 9:32 am 

Department of Health and Human Services (HHS) Secretary Kathleen Sebelius and Department of Education (ED) Secretary Arne Duncan joined with Dr. Beth Bell, Deputy Director, National Center for Immunization and Respiratory Diseases at the Centers for Disease Control and Prevention (CDC), to announce new guidance for Institutions of Higher Education (IHE) to plan for and respond to the upcoming flu season.

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.

Posted by Christy Gullion
August 21, 2009 at 9:32 am
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Posted by Christy Gullion on August 3, 2009 at 7:33 am 

With the House gone for its August recess, the Senate will turn its attention this week to passing one more spending bill, replenishing the popular Cash for Clunkers program, and confirming President Obama’s pick for the Supreme Court, Judge Sonia Sotomayor, all with the aim to leave town Friday until after Labor Day.

APPROPRIATIONS

As Congress prepares to leave for August recess, the House, which adjourned last week, has completed work on all 12 appropriations bills, and the Senate is expected to be a third of the way done when it departs Friday.  The Senate will consider its Agriculture spending measure this week.  With Senate passage of the Agriculture bill this week, the Senate will have passed four of its bills.

The Senate plans to continue floor consideration of spending bills in September, and leaders would like to get a handful of spending bills enacted before the Oct. 1 start of federal fiscal year 2010.  A continuing resolution will be needed to fund most government agencies when the new fiscal year arrives.  Democrats remain intent on enacting all 12 spending bills individually, and avoiding a massive multi-bill omnibus spending measure, as has so often been the result over the past 14 years. 

The House and Senate will begin informal and then formal conference committee negotiations to work out the differences between their spending measures.  The Office of Federal Relations will continue to advocate for funding priorities that affect the University of Washington, including congressionally-directed funding and specific programmatic (agency) funding.

HEALTH

The six Senate Finance Committee members negotiating a bipartisan healthcare overhaul bill will meet throughout the week, but will not hold a markup on any overhaul measure.  While they keep reporting that the group is making progress, no one has seen a proposal on paper.  One provision that appears close to a final decision is an insurance co-op in lieu of a public option.  The public option issue will likely be hotly debated when Congress returns to DC in September. 

The House meanwhile may be on recess, but lawmakers working on a health care overhaul still have a lot of work to do over the break to prepare to pass legislation when they return.  Democratic leaders and committee chairs will have to find a way to resolve differences in the versions of the bill approved by two committees – Education and Labor and Ways and Means – and a compromise measure approved just before the House recessed last week by the Energy and Commerce Committee that includes proposals crafted with moderate Democrats on the panel who had opposed the original bill over cost concerns.

The House is looking now to pass the bill in mid-September, a few days after Congress reconvenes. 

AUGUST RECESS

House Members have already started their August recess, with many of them back in their home states/districts.  The Senate will follow after they complete their work this week.  The WA State Delegation will spend the recess period holding town hall meetings, attending forums, and meeting with community leaders and constituent groups – with a focus on health care reform, Recovery Act implementation, and climate issues.  Many of the DC staff from these offices will be in the state, and I am arranging for several of these staff to be on campus to learn more about our priorities as they relate to the federal government. 

I will be on campus from August 19 through September 4, and am currently scheduling meetings with faculty and staff to discuss on-going University projects and issues.  The Office of Federal Relations is also gearing up on the development of our FY2011 Federal Agenda.  This agenda will likely include a continued focus on obtaining Recovery Act funding, as well as identifying new research opportunities through health care reform and climate legislation.  Additionally, we are beginning to discuss priorities for FY2011 congressionally-directed funding requests.

Please let me know if you would like to meet with me during the time I’m on campus – either to discuss the current FY2010 process, the upcoming FY2011 Federal Agenda development, or any other issue that has some federal nexus and needs some attention by the Office of Federal Relations. 

Christy Gullion, Director

Posted by Christy Gullion
August 3, 2009 at 7:33 am
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Posted by Christy Gullion on July 28, 2009 at 1:30 pm 

HHS Secretary Kathleen Sebelius today announced the availability of $200 million to support grants, loans, loan repayment, and scholarships to expand the training of health care professionals.  The funds are expected to train approximately 8,000 students and credentialed health professionals by the end of fiscal year 2010.  Today’s funds are part of the $500 million allotted to HHS’ Health Resources and Services Administration (HRSA), to address workforce shortages under the American Recovery and Reinvestment Act (ARRA).

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.

Posted by Christy Gullion on July 15, 2009 at 5:54 am 

Yesterday, House Democrats finally unveiled their comprehensive health care overhaul legislation, including details on how they intend to pay for it.  For the most part, the $1 trillion-plus plan would be paid for through a surtax on upper incomes (families with adjusted gross incomes of more than $350,000) and by more than $500 billion in savings from Medicare over 10 years.

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.

Posted by Christy Gullion
July 15, 2009 at 5:54 am
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The UW Office of Federal Relations is located in Washington, D.C., where the staff represents the University to both legislative and executive branches of the federal government, participates in a variety of national forums and advocates for UW interests. The office also serves as a portal for the federal establishment to the UW and as an access point for UW leadership to the D.C. establishment.