WASHINGTONThe 107th Congress, by general agreement, will not enter the
history books as a major contributor to medical and health policy. However,
legislation it failed to pass serves as a prologue to some of the issues the
new 108th Congress will consider during the next 2 years, said Susan
Erickson, acting director of the National Cancer Institute’s (NCI) Office of
Policy Analysis and Response. "We will probably continue to see these themes,
no matter what specific pieces of legislation come back," she said at a
meeting of the National Cancer Advisory Board.
When the last Congress adjourned in late November 2002, it had failed to
pass 11 of the 13 Fiscal Year 2003 appropriation bills, including the one for
the Department of Health and Human Ser-
vices (HHS). That meant that all HHS components, including the NCI, remained
in operation under a continuing resolution that kept their budgets at the
level of FY 2002, which ended last September 30 (see ONI January 2003, p. 4).
The new Congress immediately extended the continuing resolution, and the
House and Senate resumed work to enact the remaining FY 2003 appropriations
In the last Congress, the Senate reported an HHS budget bill that included
$4.642 billion for the NCI, an increase of 12% over its FY 2002
appropriation. That sum is unlikely to change in this session. The House,
however, failed to agree on a budget for the department. When it does, a
House-Senate conference committee will have to work out differences between
the two bills before either body votes on a final HHS budget.
The 2002 election increased the number of Republican members in both
houses and returned control of the Senate to the GOP. The Republicans now
control both the Congress and the White House. The change of power in the
Senate resulted in new chairmen of the committees that handle NCI’s budget
appropriations. Sen. Ted Stevens (R-Alaska) now leads the Appropriations
Committee and Sen. Arlen Specter (R-Penn) chairs the appropriations
subcommittee that develops the NCI budget.
When the 107th Congress ended, all unenacted bills introduced by members
of the House and Senate died with it, and they must be reintroduced before
they can be considered again. Major pieces of health legislation that failed
to win passage included:
- Medicare coverage for chemotherapy drugs and their administration. Two
committees, one in each house, held hearings last year on the issue of
reforming the system by which Medicare pays for chemotherapy drugs through
average wholesale price (AWP), a major priority for cancer organizations and
advocacy groups. However, neither reported out a bill for a vote.
- Medicare coverage for oral cancer drugs. Although this legislation had
support from a majority of members in both houses, neither one enacted
legislation, primarily because of the increased cost to the Medicare program.
- A Medicare prescription drug benefit. The House passed a bill; the
Senate did not. Both Republicans and Democrats have proclaimed this
legislation a high priority for the current Congress.
Other health-related bills that did not receive congressional endorsement
included 8 measures relating to clinical trials access, 10 in the area of
patient privacy and discrimination, and 6 that would increase access to
medical care. However, given the faltering economy, increasing budget
deficit, demands for tax cuts, and the threat of war with Iraq and ensuing
terrorist attacks on the United States, it remains uncertain how willing
Congress will be to increase funds for health programs.