‘No Action’ on Major Health Issues Likely in Congress, CQ’s Goldreich Says

Congress is not likely to achieve results on the "major health issues" that it has faced since the beginning of the year, including Medicare reform, patients' rights and the uninsured, Congressional Quarterly senior reporter Samuel Goldreich says in this week's "Congressional Quarterly Audio Report" (Goldreich, "Congressional Quarterly Audio Report," 9/3). The Senate in July rejected four competing Medicare drug benefit bills (Kaiser Daily Health Policy Report, 8/1). The House passed a Republican-sponsored bill that included a Medicare drug benefit in June (Kaiser Daily Health Policy Report, 6/28). According to Goldreich, efforts to negotiate a compromise in the Senate are hampered by "how to reconcile [Sen. Charles] Grassley's [(R-Iowa)] determination to have private health plans run a drug benefit with [Sen. Edward] Kennedy's [(D-Mass.)] goal of offering uniform Medicare coverage to all seniors." Goldreich also says that physicians and other Medicare providers are "turning up the pressure" for a bill that would reverse Medicare reimbursement cuts scheduled to take effect this fall ("Congressional Quarterly Audio Report," 9/3). Under changes mandated by the 1997 Balanced Budget Amendment, home health agencies face a 15% cut in their Medicare payments on Oct. 15 (Kaiser Daily Health Policy Report, 5/7). Goldreich calls a reversal of the cuts "a possibility but not a certainty."

Generic Drugs
Goldreich says that a Senate-passed bill (S 812) that attempts to ease the market entry of generic drugs is "going ... into limbo" because House Energy and Commerce Committee Chair Billy Tauzin (R-La.) is not likely to "ever allow something like that to reach the floor" ("Congressional Quarterly Audio Report," 9/3). The legislation, which was sponsored by Sens. Charles Schumer (D-N.Y.) and John McCain (R-Ariz.) and passed 78-21, would eliminate a loophole in the 1984 Hatch-Waxman Act that allows brand-name pharmaceutical companies to receive an automatic 30-month patent extension from the FDA for each lawsuit they file against generic drug makers for alleged patent infringement and allow brand-name drug makers only one 30-month patent extension per product. The bill also would prevent brand-name drug companies from paying generic manufacturers to keep their products off the market and would allow generic drug companies to legally challenge "frivolous patents," including "superficial changes" in a treatment's color or physical design intended only to "stifle competition" (Kaiser Daily Health Policy Report, 8/16).

Medical Malpractice
Goldreich also states that Republicans are "pushing for caps on medical lawsuit damages to stop a spike in malpractice insurance rates," but adds that movement on the issue will likely "be contained to rhetorical action." The House Judiciary Committee on Sept. 5 has scheduled a markup of a bill similar to one rejected by the Senate in July ("Congressional Quarterly Audio Report," 9/3). The measure, offered as an amendment to the generic drug bill, would limit punitive damages in malpractice suits to twice the amount of compensatory damages, require that 50% of punitive damage awards go to state activities, restrict attorneys' fees and cap non-economic damages at $250,000 (Kaiser Daily Health Policy Report, 7/31).

The Uninsured
Goldreich says that while "there might be a flurry of rhetoric [about reducing the number of uninsured] as Democrats, Republicans and the White House take up debate on a new economic stimulus plan," it is likely that "the only help" will go to U.S. workers displaced by foreign trade ("Congressional Quarterly Audio Report," 9/3). That aid, which provides uninsured trade-displaced workers with a refundable tax credit to cover 65% of the cost of their health insurance premiums, was included in the trade bill signed into law by President Bush last month (Kaiser Daily Health Policy Report, 8/7).
Goldreich's report is available online.