THIS WEEK ON THE HILL

The Senate is scheduled to tackle several pieces of health-related legislation. As part of "Health Week," Senate Majority Leader Bill Frist (R-TN) has arranged for a cloture vote on two bills that would cap non-economic damages in medical malpractice lawsuits. The Medical Access Protection Act of 2006 (S. 22) introduced last week by Senator John Ensign (R-NV) would cap total non-economic damages in malpractice lawsuits at $750,000. A second bill, S. 23, sponsored by Rick Santorum (R-PA), would cap non-economic damages at similar levels in malpractice lawsuits filed against OB-GYNs. A cloture vote on S.1955, a bill to assist small businesses in purchasing health insurance, is scheduled for tomorrow.

Senate Floor. The Senate convenes today and is scheduled to consider the Medical Access Protection Act of 2006 (S.22), the Healthy Mothers and Healthy Babies Access to Care Act (S.23). The chamber will then turn to the Healthy Insurance Marketplace Modernization and Affordability Act (S.1955) tomorrow and could also address conference reports on pension reform and tax reconciliation later this week.

The House is expected to consider its Defense authorization bill (H.R. 5122) this week. The measure allows for an end-strength of 350,000 for the Army National Guard (17,000 above the Administration's request of 333,000) and 107,000 for the Air National Guard. In addition, it provides $318 million for the Army National Guard to fund equipment requirements for the 17,000 increase in end-strength.

The House could also return to consideration of the FY 2007 budget resolution if negotiators are able to resolve differences over efforts to raise the overall discretionary spending level and new limits on emergency spending.

Even without a budget resolution, the House Appropriations Committee is scheduled to meet on Tuesday, May 9, to consider proposed 302(b) allocations by Chairman Jerry Lewis (R-CA). http://appropriations.house.gov/_files/302bscof.pdf 302(b) allocations is the distribution, pursuant to section 302 of the Congressional Budget Act, of new budget authority, and outlays to House and Senate Committees. The allocation, which many not exceed the corresponding amounts in the budget resolution, usually is made in the joint explanatory statement that accompanies the conference report on the budget resolution. Since the House has yet to pass a budget, the Chairman's plan would divide $873 billion in FY 2007 discretionary budget authority (assumed from the proposed House Budget Resolution) among the committee's eleven subcommittees. It shifts $7.4 billion from the President's budget request for defense, foreign affairs, veterans and legislative accounts into domestic spending. In addition, the committee is scheduled to mark up FY 2007 spending bills for Agriculture, Interior-Environment, and Military Quality of Life-VA.

The House could also take-up a bill (H.R. 5254) that would coordinate the permitting process for siting new refineries. The measure was rejected 237-188 last week under suspension procedures that require a two-thirds majority, but it may be considered under regular order this week.

House Floor. The House meets in pro forma session today with no legislative business scheduled. The chamber will also consider bills under suspension of the rules including military personnel retirement accounts, rural health care and the FY 2007 Defense Authorization Appropriations Bill.

SENATE PLANS PROCEDURAL VOTES FOR MALPRACTICE, ASSOCIATION HEALTH PLANS

Senate Democrats and Republicans will "square off" this week over different approaches to improving the country's health care system, CongressDaily reports. As part of this year's "Health Week," Senate Majority Leader Bill Frist has arranged a cloture vote for two bills related to medical malpractice lawsuits. S. 22, the Medical Care Access Protection Act of 2006, was introduced last week by Senator John Ensign (R-NV). Under the bill, a patient can recover up to $250,000 from a healthcare provider and up to two healthcare institutions each for a total of $750,000. The bill would also guarantee timely resolution of claims by mandating that healthcare lawsuits are filed within three years of the date of injury and establishes standards for expert witnesses in medical liability trials and limits attorneys’ fees on a sliding scale. S. 23, sponsored by Senator Rick Santorum (R-PA) would cap non-economic damages at similar levels in malpractice lawsuits filed against OB-GYNs.

On Tuesday, May 9, Senator Frist has arranged a procedural vote for a bill sponsored by Senator Mike Enzi (R-WY). S. 1955, the Healthy Insurance Marketplace Modernization and Affordability Act, would assist small businesses in providing affordable health care coverage and is viewed as an alternative to Association Health Plans or AHPs, long opposed by some Governors, Insurance Commissioners, and Attorneys Generals. The Enzi bill would retain state regulatory authority; in addition, it would allow small businesses to provide coverage that varies from current state requirements as long as it meets the requirements of a state employee health plan in one of the five most populous states (CA, NY, TX, FL, IL). It would also create a national insurance board that would attempt to harmonize state regulatory laws in the areas of form and rate filing, market conduct review, prompt payment of claims and internal review. A variety of business groups have endorsed the proposal, while many organizations have chosen not to take a position. Many groups have acknowledged progress moving away from the AHP model, but still caution that superseding states' small insurance rules could potentially do unintended harm and have a negative effect in some states.

The procedural votes, which Frist requested last Friday, seek to invoke cloture in order to end debate and allow a Senate floor vote on both bills. In 2004, the Senate failed to invoke cloture on malpractice legislation. Senator Santorum said currently no Senate Democrats support malpractice bills under consideration this week. Senate Democrats have said they might consider a floor vote on AHP legislation provided they can hold an up-or-down vote on substitute legislation.

SENATE PASSES FY 2007 SUPPLEMENTAL APPROPRIATIONS BILL

Last week, the Senate approved by a vote of 77-21, its $109 billion FY 2007 emergency supplemental appropriations bill (H.R. 4939) providing approximately $70.9 billion for military operations in Iraq and Afghanistan, $28.9 billion for Gulf Coast hurricane recovery, $2.6 billion for pandemic flu preparations, $1.9 billion for border security upgrades, $4 billion in agricultural assistance, and $650 million for port security. The Senate bill, which exceeds President's Bush's ceiling of close to $14 billion, set up a clash with the White House and the House, which earlier this year approved $17 billion less than the Senate. During floor debate, the chamber approved several amendments which include:

Redirecting $1.9 billion from military operations funding in the measure for border security programs;
Cutting $15 million targeted for seafood promotion;
Adding $289 million to reimburse victims who are harmed from taking an experimental vaccine for pandemic flu;
Ensuring that affected states receive at least 3.5 percent of the $5.2 billion included for Community Development Block Grants;
Providing $2.2 billion ($1.7 billion more than approved by the Senate Appropriations Committee) for levee repairs in New Orleans, $30 million for Gulf Coast election assistance, and $30 million to reduce the risk of fires and alleviate the effects of bark beetle infestation;
Increasing the Federal Emergency Management Agency reimbursement rate of Hurricane Rita damage claims to 90 percent, with states paying 10 percent and;
Requiring that all contracts for hurricane relief exceeding $500,000 be awarded using a competitive bidding process.

The bill also provides money for reimbursement for states that educated students displaced by Hurricanes Katrina and Rita. The White House reiterated the president's promise to use the first veto of his presidency on the spending bill should it exceed his limit. Both the House and Senate anticipate that funding will be cut during conference negotiations to bring the measure more closely in line with the President's request of $94.5 billion.

DEFENSE AUTHORIZATION BILL INCLUDES NEVADA PROJECTS

In a joint press release, Nevada Senators Reid and Ensign announced last week that the National Defense Authorization Act includes funding for crucial military projects in Nevada. Senator Harry Reid, a member of the Appropriations Committee will work to get funding in the Military Construction Appropriations Bill for these important projects.

Senator John Ensign, Chairman of the Readiness and Management Support Subcommittee, successfully fought for an amendment that will reform the way defense contracts are awarded by insisting on performance and results before contracts are granted or renewed.

The bill provides almost $68 million dollars for military construction projects located throughout Nevada:

• Almost $50 million for unmanned predator facilities at Creech Airfield in Indian Springs

• $7.7 million in range upgrades at Fallon Naval Air Station

• $4.8 million for an Airfield Rescue Fire Station at Nellis AFB

• $5 million for the replacement of the Nevada Air National Guard vehicle maintenance complex in Reno

• $500,000 for the planning and design of a water treatment plant at Hawthorne Army Depot

The National Defense Authorization Act for Fiscal Year 2007 will be presented to the full Senate for consideration later this year.

Information taken from a joint Reid & Ensign press release: http://ensign.senate.gov/record.cfm?id=255170&

HOUSE PASSES PORT SECURITY ACT

Last week, the House passed the Security and Accountability for Every Port Act (SAFE Port Act) by a vote of 421-2. The measure was called a major step in protecting the nation's shipping system against terrorist attacks. Critics however, argue that containers entering the country will still not be inspected. Democrats argued they were not allowed to debate their amendment calling for scanning 100 percent of the 11 million containers entering the nation's ports annually, prior to their departure overseas. Republicans said that approach is not technically feasible and said "endangered layered defenses in which federal inspectors inspect high-risk cargo at 22 ports overseas (accounting for 98 percent of cargo shipped to the United States) is the way to go for now.

Currently, about 6 percent of containers entering the U.S. are inspected; the legislation comes in the wake of a scuttled deal a United Arab Emirates-controlled firm planned to assume management of terminals at several eastern U.S. ports. The bill was a bipartisan effort by the House Homeland Security Committee, which approved it 29-0.

The legislation would require the Department of Homeland Security (DHS) to develop and implement a plan for improving the Automated Targeting System for identifying high-risk containers moving through the international supply chain; establish in DHS a Director of Cargo Security Policy to coordinate cargo security policies and programs; require DHS to consult with federal and local authorities when determining the establishment of maritime security centers; ensure that mechanisms for sharing terrorism threat information under the new Port Security Grant program are interoperable with federal state and local agencies; and, require states to submit to DHS biographic information on current and future employees who have access to secured areas of seaports (comparing such information against terrorist watch lists). The measure authorizes $5 billion over six years.

A Senate port security bill (S. 2459) was approved by the Senate Homeland Security and Governmental Affairs Committee on May 2, but no further action has occurred.

SENATE ARMED SERVICES COMMITTEE APPROVES RESOURCES FOR NATIONAL GUARD

The Senate Armed Services Committee approved the National Defense Authorization Act for FY 2007 (S. 2507) last week. The measure would provide an end-strength of 350,000 for the Army National Guard (17,000 above the Administration's request of 333,000) and 107,000 for the Air National Guard. In addition, the committee approved $318 million for the Army National Guard to fund equipment requirements for the 17,000 increase in end-strength. The House Armed Services Committee took similar action last week as well (please see story below).

HOUSE ARMED SERVICES COMMITTEE APPROVES RESOURCES FOR NATIONAL GUARD

During its markup of the National Defense Authorization Act for Fiscal Year 2007 (H.R. 5122), the House Armed Services Committee approved an end-strength of 350,000 for the Army National Guard (17,000 above the Administration's request of 333,000) and 107,000 for the Air National Guard. In addition, the committee approved $318 million for the Army National Guard to fund equipment requirements for the 17,000 increase in end-strength.

NATIONAL STRATEGY PLAN FOR PANDEMIC INFLUENZA

The White House Homeland Security Adviser, Fran Townsend, announced the National Strategy for Pandemic Influenza plan which includes more than 300 actions and guidance for federal departments and agencies. In addition, the plan sets some "expectations" for state and local governments and other non-federal entities. The report states that pandemics are global events, but that individual communities experience pandemics as local events. It further says that state and local governments, with clear guidance from the federal government, should be prepared to implement community-wide measures, such as school closures and suspension of public gatherings, to halt the spread of disease. The report outlines four federal priority actions for implementation:

advance international cooperation by building capacity and ensuring rapid response;
limit the arrival and spread of a pandemic through early warning and situational awareness with proper screening protocols;
provide clear guidance to all stakeholders to ensure effective risk communication; and,
accelerate the development of countermeasures with rapid diagnostics, stockpiles of vaccine and antiviral medications, and technology and production capacity for influenza vaccine.

For more information on the plan, click here: http://www.whitehouse.gov/homeland/pandemic-influenza-implementation.html

HOUSE SUBCOMMITTEE HOLDS HEARING ON MEDICARE DRUG BENEFIT

The House Ways and Means Subcommittee on Health held a hearing last week to examine implementation of the Medicare Part D drug benefit. Centers for Medicare and Medicaid Services (CMS) Administrator Mark McClellan testified at the hearing. Members questioned McClellan about the success of the outreach and enrollment effort to eligible beneficiaries and debated the idea of extending the May 15 enrollment deadline to sign-up beneficiaries. Also discussed was a recent Congressional Budget Office (CBO) report, which estimated as many as 1 million beneficiaries who have not yet enrolled would sign up for the drug benefit this year if the early enrollment deadline were extended through December. According to CBO, such an extension would cost the Medicare program over $3.4 billion over ten years. In addition, subcommittee members questioned McClellan about a recent General Accounting Office (GAO) report that examined the quality of CMS' communication to beneficiaries about the new Part D benefit. The GAO report recommends improvements to CMS communications, including documents, the 1-800 number, and the Medicare website. McClellan suggested that the GAO report did not represent a complete and accurate picture of CMS' Part D communications.