Category: Health/Medical

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 13^th 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 6^th.  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.

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 30^th, 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

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 30^th 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